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CITY OF ORONO APPLICATION FOR PLUMBING PERMIT <br /> Box 66 ( 1335 So Brown Rd ) 11 <br /> Crystal Bay, MN 55323 <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 /> *************************************************************************** <br /> JOB SITE ADDRESS: , `" <br /> Occupancy Type: Residential ( ___— Commercial <br /> OWNER'S NAME: nr"(7. o X- M- L-:- Phone No. : <br /> Mailing Address: go,'„ -? -1 City: r ;T,. t /3‘_ <br /> CONTRACTOR'S NAME: 2-4-k-,7 (0( Se.---,--- Bus. No. : <br /> Mailing Address: 3D-�a v✓ r�r ii_el,-• c,.✓ City: i Zip: /j`c-=iZ.-<j <br /> Master Plumber' s State License No. : - <br /> _iG 7 `$ 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 /> -4T - <br /> Water Closet a Sewer Ejector --- <br /> Lavatory Laundry Tray <br /> Bathtub Washer <br /> Shower I L Water Heater <br /> Kitchen Sink - ----- Water Softner <br /> Disposal <br /> jI _ Wet Bar <br /> j <br /> Dishwasher l Sump Pump <br /> Sillcocks Misc. (List) <br /> Floor Drains U r!w4„l r <br /> *************************************************************************** <br /> 1. Fixture Fee The minimum permit fee is $30 .00 $ <br /> Compute number of fixtures / x $8/fixture ° <br /> 1 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) $ ; 6? , .(:) <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 /> Signature of Applicant: 4-2„,,z, W� Date: ::3 <br /> -<_a-) -c1?' <br /> .49 <br />