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� � <br /> � CITY OF ORONO APPLICATION FOR PLUMBING PERMIT <br /> Box 66 (1335 So Brown Rd) <br /> � Crystal Bay, MN 55323 �� .s�' , � �' <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 contr.actors 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 /> rt*****************,t************** ****,t** * * ****************,t********** <br /> JOB SITE ADDRESS: -1� �fL������t� �,�' <br /> Occupancy Type: _ Residential Commercial <br /> OWNER'S NAME: /Zl,�C!l, , z-CX,� Phone No. : <br /> Mailing Address: City: <br /> CONTRACTOR'S NAME: I [s�t � � Bu s. No. : ��J 7'IO�� <br />� Mailing Address: t`'Z � _�, City: Zip: <br /> Master Plumber' s State License No. : � 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 /> ------------- ---- ----a- --- ---�----- ------ ------------- ---- --------- --------- ----- <br /> 47ater Closet �- �- � Sewer E 'ector <br /> ------------ --- -- -- -�--- ---- ------�---- -- --•---- ------- ---- <br /> Lavatory � � Laundry Tray ' <br /> Bathtub------ ---- ---—---- --- ---- ------ Washer------- ---- ---•----- --------- ----- <br /> ------------ ----�------ --L---- ----- ------------- ---- --1---- --------- ----- <br /> Shower ' �, --__-_ Water Iieater <br /> -------------�-----�--.----- --------- ------------- ---- ---.�---- --------- ----- <br /> Kitchen Sink 'i f -_--__ Water Softner <br /> -------------y---- -•---- ------ ----------- -- --•---- -------- ---- <br /> Disposal I_ ' Wet Rar <br /> -------------1 --- ---- ----- ---- ----------- -- --•---- -------- ----- <br /> Dishwasher _ I- � Sum Pum <br /> ------------ 1 --- --- -- --�--- ----- --p----p--- --- ------ ---------- ----- <br /> SillCocks MisC. (List) � <br /> ------------- ----- ---•--- ----•---- ----- - <br /> Floor Drains � <br /> rt********************************************rt*****************,k***,k,k****** _ <br /> l. Fixture Fee The minimum permit fee is $30 .00 $ <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 applicat.ions) $ 1.50 <br />� <br /> 4. TOTAL PERMIT FEE (add lines 1-3 above) $ <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 l�finnesota, and certifies that all statements made on this <br /> application are complete, true and correct. <br /> Signature of A�:plicant: ���, � Date: S 'Z2- � 1 Z <br />