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11/20/2017 MON 15: 09 FAx Ark MdndgOmOnt �002/OOa <br /> �� ` ,�� � '� ���'DZ <br /> � ��05 <br /> City of Orano FOR ClTY USE ONLY <br /> �NO P.o_Bax sg Date Receiv�d: <br /> 2750 Kelley Pa►kway permit# <br /> Crystal Bay,MN 55323 <br /> �'p �� (952)249-4600—Maln �p���y. <br /> '� s P (952)249-4616—Fax <br /> Amount$; <br /> CITY OF OROidQ—PLUMBING PERMIT <br /> (All Commerclal Permits Must be Approved by the State Prlor to City Approval) <br /> httn://www.dli.mn.saov/CCLD/PDF/ue �lumbnlanrevanp.adf <br /> GENERAL 1NFORMATION <br /> 1. You may apply for plumb�ng permit5 by mail pr in person at the City o�ices. Applications will be <br /> reviewed and a permit wlll be issued wlthtn two working days. <br /> 2. Permit cards will be sent by retum mail after a review is oompleted. PERMITS ARE NOT VALID <br /> UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS <br /> posrEo or�TH�_,�QB SITE• <br /> 3. Plumhing permits may be Issued ONLY to Ilcensed plumbing contractors and to property awners <br /> residing in the dwelling. <br /> 4. When any new constructian or rembdeling Is Ihvolved,a sepawate bullding permlt must be obtained. <br /> 5. All work must be done in accordance with State Code requirements. <br /> 6. All work must be InspeCted and afr tested before It is Covered. Call(952)249-4600. <br /> (24�8 hou�notice requlred) <br /> 7YPE OF PERMIT(Check All That Apply) <br /> p� ReSidential ❑ Cammerdal(Approval Requlred) [Backflow Dcvice:❑AVB ❑PVB] <br /> /� <br /> ❑ New �Additional ❑Repairs �Replace <br /> ❑ In Accessary Structure7 <br /> "You will need �rior aoororal and may need CUP. (Per Orono Clty Code, Chapter 78,Article IV) <br /> Job Slte/Owner Information: <br /> Site Address: ���� 't"�`�' f-� �+ <br /> Owner:����S��f M�1'���-I�ailing Address: ���� P� ��� <br /> City; �I�D l�� Z;p: ��J3�A�1 <br /> Home Phone: ��- ��'2��',�� Afternate Phone: �5�.: Z-��;��� <br /> Contractar Information: <br /> Contractor; �1�V�l�n._��-VUC�.�1� Y`� on 1�eraon: ��1'�. W�� ���V� <br /> Address: S�� CVr�vVtOl�'a/�w� ���State Bond#: ����-'f.��� <br /> City: ��.�.� �(�, Zip;S �{Z-� �xpiretion Date: ��-" ��"��" <br /> Phone: � ��-�Z-��"��'�� �1lternate Phone: <br /> ❑ Insurance—Current: �,�W�.dl� <br /> Page 1 <br />