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._"� ��Z <br /> CITY OF ORONO APPLICATION FOR PLUMBING PERMIT <br /> �,. . � 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 �hhtij�di#igt�ez�n�f�`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 honr notice reqnired. <br /> *************************************************************************** <br /> JOB SITE ADDRESS: __���,(�� '{��1 i � +��,���y �V�� <br /> Occupancy Type: � Residential Commercial <br /> OWNER'S NAME: �, ��„-�'� Phone No. : �7c� - �����; <br /> Mailing Address: j��� h, ��i�;, (��-���, City: y,xi-� I�,(�,� <br /> —� <br /> CONTRACTOR'S N��������� ����� ���'��,������� Bus. No. : <br /> Mailing Address: �-�`%��,� t... � ,�`�( City: Zip: <br /> Master Plumber's ����q���ewW�. :�r�n�r City Cert. No. : <br /> ******************,r***** �r* *l��4",�**** '� *****************,t***********,t***** <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 <br /> Bathtub Washer <br /> ------------- -----�-------- -- -- ------ ------------ ---- -----�--- --------- ---- <br /> Shower Water Aeater <br /> , Kitchen Sink ' ___--_ Water Softner <br /> -------------�---- --�----- ------- ------------ I- --�---- -- --- ---- <br /> - - - - - - - --- - - <br /> Disposal I_ ----- Wet Bar <br /> -------------1 --- ----- ----- ----------- -- --�---- -------- ---- <br /> Dishwasher I- Sum Pum <br /> -------------1 --- ---- -- ------ ---- --p----p--- -- ----- -------- ---- <br /> Sillcocks Misc. (List) <br /> I'loor Drains <br /> *************************************************************************** � <br /> 1. Fixture Fee The minimum permit fee is $30.00 $ �j��_ ('_`���� <br /> Compute number of fixtures x $5/fixture <br /> x $3/fixture reset <br /> 2. State Surcharge $ .50 <br /> �, <br /> � 3. Postage & Aandling (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PERMIT FEE (add lines 1-3 above) $ ��p�� <br /> ******************************************************�******************** <br /> The undersigned hereby applies to the City of Orono for issuan<;e 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 /> � <br /> Signature of A�;plicant: ���-�� Date: � '�°�—'� <br /> GUL, AN WATER CO�d:��1TpONING ; :;,,: <br /> . � �4=: . . . . , ...... � � � . • � � ,._ . . . <br />