Laserfiche WebLink
_(:ITY OF ORONO APPLICATION FOR PLUMBING PERMIT <br /> I' Box 66 (1335 So Brown Rd) <br /> Crystal Bay, MN 55323 <br /> *************************************************************************** <br /> General Instructions <br /> 1. You may apply for plumbing permits by mail or in person at the City offices. <br /> 2. Mailed in applications are subject to the postage and handling fees shown below. <br /> Permit cards will be sent by return mail the same day the application is received. <br /> 3. Permits are not valid until you receive a permit card. <br /> 4. Work must not begin unless the permit card is available on the job site. <br /> 5. Plumbing permits may be issued to licensed contractors only. <br /> 6. When any new construction or remodeling is involved, a separate building permit must <br /> be obtained. <br /> 7. All work must be done in accordance with State Code requirements. <br /> 8. All work must be inspected before it is covered. Call 473-7357. <br /> 24 hour notice required. <br /> *************************************************A************************* <br /> JOB SITE ADDRESS: i (O 0 Cli o O: -z ) ---0 <br /> Occupancy Type: V Residential Commercial <br /> OWNER'S NAME: l� Belo Phone No. : 47 7 7 b i <br /> Mailing Address: ( ) OV-ONO nt2-C-1 .l) 124 City: WA,y2 - - <br /> CONTRACTOR'S NAME: Bus. No. : <br /> Mailing Address: City: Zip: <br /> Master Plumber's State License No. : City Cert. No. : <br /> *************************************************************************** <br /> PLUMBING FIXTURE SCHEDULE <br /> (Show number of fixtures of each type on each floor) <br /> FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER <br /> T <br /> Water Closet Sewer Ejector <br /> Lavatory Laundry Tray I <br /> Bathtub Washer <br /> -- ----- <br /> F _4 --0 <br /> Shower Water Heater <br /> Kitchen Sink . 1 Water Softner <br /> Disposal <br /> 1 I -_` ------ Wet Bar <br /> 1 <br /> Dishwasher I / - Sump Pump <br /> Sillcocks I Misc. (List) <br /> Floor Drains <br /> *************************************************************************** <br /> 1. Fixture Fee The minimum permit fee is $30 .00 $ *fj, CV <br /> Compute number of fixtures (.;, x $8/fixture <br /> x $5/fixture reset <br /> 2. State Surcharge $ .50 <br /> 3. Postage & Handling (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PERMIT FEE (add lines 1-3 above) $ �)U c�' <br /> *************************************************************************** <br /> The undersigned hereby applies to the City of Orono for issuance of a Plumbing Permit, <br /> agrees to do all work in strict accordance with the ordinances of the City and the <br /> regulations of the State of Minnesota, and certifies that all statements made on this <br /> application are complete, true and correct. <br /> t . , <br /> Signature of Applicant: 1 V '\ L' Date: ///:0 ((q 2/ <br />