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1991-003569 - final only
PERMIT CITY OF ORONO ' �" PERMIT TYPE: 1335 Brown Rd. South • P.O. Box o6 Permit Number: , Crystal Bay, Minnesota 55323 Date Issued: ���}������ (612) 473-7357 �-��:�='�"=`�=� SITE ADDRESS: �����'r{��•�i �,�i ai z:1 '�tst�r`�h4Ji�;t�� Qn ;• � ��� D�SCFNPTI(��1:-1 ���-'�`'�'-�1-t�+y;i 7 r �� I' ;f�l-iL_ i_I�°��,_:7, 1='IUfitr�ill'a F'*'t'fiil�_ �Y�'!= €=�;���?i;�•_� L ��.tr.. �`l���i��..�i��:a E��+����;:: �;rc�� ��:=;�.�.rt_#`�iC�E '� ,,� ��'rs n� n'� s�ga„��au�w 4� � ;�.�s,.�' � a � yµ� .�'y�Mir�'r�,".'t'd�{t °� p ��. a �i.av '� _ ����"'� ""'�� F � �y�,u �+�x�'��k�ti '-�sV��y�„�„y t�< l�, a,�, il i'� �' +'� �5�� '� d� �� _ ��' 4. ��+'� �{ � � k�� '��,� .��' �� :�` 4 ���� �,: r '1 !M� �k' '"�kt�'.�"� a"C �'y,� ,�; n��'4' �" �jp���yl i�W� �y ��.i�4 � '� � N �: $ f�'�i,�;: •'Y'� �. r� � � ���� t � '. Al i� �:�k 3 4 /' . 8av. �'ry��.��bh�i; �'n ��° �� " � `� r+ k�,��g�,�. 'i..�,�u. �y .,r ?L t„�r,,s�1"t�,ay{x ,x REMARKS: FEE SUMMARY: L•1 1!. VF !'�VI� �1� .L7/t3}71T�LL l}�1�14L 'd�tw.;'\�L�� 1�f tr �1.J,p�t�A�tt +3ViYY :i) ,i l{_) a C�el'�C �CC �� .%4 c.'�"irTi a � r i�i vitif .rv T��La 1'L`�`ic!i'�t ------- --�. ri{3 �'•r1L •i +rt �!Y ��finl F►�e Y�:�,�x~�iy ..:.,L�t' _ ;� 4�,...�„ !1 LL-t 11�j�'=��l�1� �� ,�:+��ti?%.•'1 i'ttt S� �t('!� T i:4+'?� rr� �nc 4� ��v 1 V !1 V•c. i!�%�v�r 3i CONTRACTOR: OWNER: -- r�����lic�nt. -- THi:i�iF':�t.;�d F'LE`C� t -,,,:�;:;'�����. �.�TE I h���; �� }-::�=�F'�'�Ll�i��f � 4 �.L•«i / `++.� !�' i+ L'��i,_ji.�j, i°{T 1,�����._����'af'•.i`j �{1�E113 i���� �� �\�4��i ��`J*.���`��,�ti�� �� '`' - i i i"v' :'Y - - - _- i °�i;i�i��{4{ t"i�y� _��'rf-. : : -,., _ ,- -•-• �-• _--- ---- ----- - __._.__..-_.._ __-- ----__ _ - ___ _ __ _ _ _ _ E,t_�.it�1 ','�::`_ , : �. , 2,. �: �: •�• z_r:•:! r,r.,i • -i-.-,-. r-,�-� ,� T —.t.[ --: h. ; ry.i,i� _ _F-1 7,-;,r�E:i Fr i i �' ;'-' r � !":C :_iiSsi;�n`.-.��_4ti�i j r E--�it_C�i I'lr_t_:l iL:�,l � r�,?lt ������"�%�_!3�1 4 �.! F-it-li'�•.G 1 .!.__flE= 1-- !.i :i"F'1_ Y�.`E_.`+i _� ` •TT'i? } , -�:-'�{_1;'i�(s ;yi ;_' 'r'z'',:�t�'.�t_�� ;;_i �,1_t ri?.y_ �#i tkit=�. �i`� _�i 1:i�_•T .:t_fi'�t'��!�?�'����_ �s i t'1 i-+�_�. �,t F s �_1i- ::"':�a ':�..'+7-.i _ . .. . :. - ' Z - . _ . ._.. _ s. ._ . .L..i � . . . .... F:.�• : �r. . i"�r':�=4iTi'ir'F?���.: ! r �_�F't+_li3s_� E_.;�'7t_`!,i4!-�.tl.S_•=. t-.t ... . y � . _.. �_ : ;•; : 3',ill� i.i � _ _ � ..._ _. -�— - ._. _ . . .. . . _. i'yi t.i� r-, � r�. �'�d��o.�� APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE ,�j,(„�+� �� ' CITY OF ORONO APPLICATION FOR PLUMBING PERMIT Box 66 (1335 So Brown-,Rd�=-, Crystal Bay, MN 55323� � � Q ***********************************************************�**�*�r********** General Instrnctions 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 handlinq fees shown below. Permit cards will be sent by return mail the same day the application is received. 3. Permits are not valid until yon receive a permit card. 4. Work must 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 sep �b�rildi_n�-�i�,�t must . be obtained. ��� � ' � � : : , ... 7. Al l work must be done in accordance with State Code require �nts. _ ;<,.;l 8. All work must be inspected before it is covered. Cal 1 473-7357: 24 honr notice reqnired. ******,t******,t*,t******,t,t******,t****************************,t*************** JOB SITB ADDRESS: O�((X�� o�(,C GlQ Y-L t�C�p c'�� - Occupancy Type: �_Residenti Commercial �, 1 OWNER'S NAMB: Phone No. : , g~ ' � �-- - Mailinq Address: City: CONTRACTOR'S NAME:��nm�����nr����o. ��'� Bus. No. : �� -`�� _ Mailing Address: ��c�n4 M-�kn .�r,rl,����r-i�.e 2 City: t�h-l-kc�. Zip: � Master Plumber's State License No. : �11�'1le'� City Cert. No. : � - ***********************************,t*************************************** �- " PLIIMBING FIXTIIRE SCHEDIILE - (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 ------------- ---- ---�----- ---�---- ------ ------------- ---- ----•--- --------- ----- h'ater_Closet-�----�------- --- ---- ------ Sewer-Ejector --- ---•----- ---------�----- . � - - - Lavatory � ; Laundry Tray Bathtub -----�----;-------- -------- ------ Washer------- ---- -- -- -��---I ----- Shower -------�----�------- -- --- ------ Water Heater- ---- ---^----- --,I��---- - . -------------�----` --�----- -------- ------ ------------- ---- ---.- -- ---- = 4 - : ',-=• Ritchen Sink � + I Water Softner -------------------�--�----- -------- ------ ------------- ---- -------- ---�-�j�-- - Disposal � Wet Bar � �� -------------1---- ---- ----- ------ ------------ -- ---.----- �----- ---- Dishwasher---�- - - - - - Sump Pump - - - - -- . Sillcocks Misc. (List) Floor Draina ------------- ----- ----=--- --------- ------ ------------- ---- -------- ---------- ----- ****************************************** **************************** 1. Fisture Fee The minimum permit fee i $30.0 $ �� �CX'� Compute number of fixtures x $5/fi � " x $3/fixture reset 2. State Surcharge $ .50 3. Postage & Handling (Only mail-in applications) $ 1.50 4. TOTAL P$RMIT FBE (add lines 1-3 above) $ C )c�.�'Y� ********************************************************* ** ************* The undersigned hereby applies to the City of Orono for issuance of a Plumbinq Permit, agrees to do all work in atrict accordance with the ordinances of the City and the regulations of the State of Minnesota, and certifies that all statements made on this application are complete, true and correct. Signature of Applicant��i-�ie�/,� C1��� Date: � -o�� "��