HomeMy WebLinkAbout1992-004470 - chge sewer ln/house _ �r�Ml�
CITY OF ORONO PERMIT TYPE: ��i�t�ME:jNG
1335 Brown Rd. South • P.O. Box 66 Permit Number: {��.�'�'�t�
Cr stal Ba , Minnesota 55323 i��l��=�'�i
y y Date Issued:
(612) 473-7357
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DESCRIPTION:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE C�.�J
CITY OF ORONO 1 � APPLICATION FOR PLUMBING PERMIT
Box 66 (1335 So Brown Rd)
Crystal Bay, MN 55323 �/�� ��`,
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General instructions
1. You may apply for plumbing permits by mail or in person at the City offices.
2. Mailed in applications are subject to the postage and handling fees shown below.
Permit cards will be sent by return mail the same day the application is received.
3. Permits are not valid until you receive a permit card.
4. Work muat not begin unless the permit card is available on the job site.
5. Plumbing permits may be issued to licensed contractors only.
6. When any new construction or remodeling is involved, a separate building permit must
be obtained.
7. All work muat be done in accordance with State Code requirements.
8. All work must be inspected before it is covered. Call 473-7357.
24 honr notice required.
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JOB SITI3 ADDRESS: .J7 g�5 �� �� `��s��
Occupancy Type: Residential Commercial
OWNER'S NAME: ��(�'d ����ti��� phone No. :
Mailing Address: City:
CONTRACTOR'S NAME: c Bu s. No. : ����/���
Mailing Address: � � City:6�+� Zip: � �S�
Master Plumber's State License No. : , — City Cer No, :
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PLIIMBING FIXTURE SC$EDULE
� (Show number of fixtures of each type on each floor)
FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER
------------- ---- ----+----- ---T----- ------ ------------- ---- ----�---- ------- ----
Water Closet_�- Sewer Ejector
---- ---- ---�----- --------- -----
Lavatory Laundry Tray
--- ---- ---•----- --------- -----
Bathtub Washer
------------- ----- ------- ------- ------ ------------- ---- ---------- --------- -----
Shower Water fIeater
-------- ---- ---•----- --------- -----
Ritchen Sink I Water Softner
-------------+----- --�----- -------- ------ ------------- ---- -------- -------- ----
Disposal Wet Bar
-------------1----- --_--- ------- ------ ------------- --- ---.---- -------- ----
Dishwasher Sump Pump
---- ------- ---------- -----
Si11COCkS Misc. (List)
------------- ----- ---•--- --------- ------ ------------- ---- ------- --------- --
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Floor Drains ( • ' - _�,�;;�
4",�t j2 �Ct C c C�°� .�',C �F �/c• �,. �-
------------- ----- ---�---- ---��- ------ ------------- ---- -------- ---------- -
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1. Fixture Fee The minimum permit fee is $30.00 $
Compute number of fixtures x $8/fixture
x $5/fixture reset
2. State Surcharge $ .50
3. Postage � Handling (Only mail-in applications) $ 1.50
4. TOTAL PBRMIT FEE (add lines 1-3 above) $
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The undersigned hereby applies to the City of Orono for issuance of a Plumbing Permit,
agreea to do all work in strict accordance with the ordinances of the City and the
regulationa of the State of Minnesota, and certifies that all statements made on this
application are complete, true and correct.
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Signature of Applicant: i Date: �� / / `