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HomeMy WebLinkAbout1995-007297 - vacuum breaker PERMIT CITY OF ORONO �, �. PERMIT TYPE: : - 2750 Kelley Parkway- P.O. Box 66 Permit Number: �'±:'���-�, V Crystal Bay, Minnesota 55323 ` ' � �+.`� (612) 473-7357 Date Issued: - _ _ SITE ADDRESS: ._�`�'.� -'.�`��`_�:�: 'Y°�� � :, .._�:`.: DESCRIPTION: , _t_�.-. ��::i'�;1 �`':,'�.._ _. . . . .'. . '..._�. 1 _�'=`r_`:. r�;�7 �� ; - � ; t i i::> ;_:ti`, . _ _t�C�:�.::_i i�� �_xj:_t; .. . . C�k: _�.!_.%�".�" __ ._.�3 ��.�'' .€i�ij . _ _. ..._.._ i.I•:c._a� REMARKS: FEE SUMMARY: - . _ . _. .�.- �:� - _ �_.�.�,�= ._.-.-. . _ .- - - - �'�`��'�-- -� � —______ '�i . ,�;_, '_. �(;�k� _.�_.�._.._._. ; ��r�-ti._ �':' � . _ . '�� '_:;��T•=_ __._ _�..�.�'i^i CO,NIRA�TOR r ,.:. -� � OV�INER :..:- .� E. . �::. - r : � :� [ ; ;._;:7 .�.. . . _ .. . ;t. ___ t�_. .�� r . . • . ��.� : ::C-}-�..� . _'`. � - �. _ - - _ - . �;:i�E�!-.�-.� r'vl` ., c.,,...'i : � �_�, r-:.I � � _ . _ » "'L , . -. -,: ; _ , •: • ,_:,.; . : . � . _.. _. . . . . . . _- -. __ .. . _. _ . . .... . .i_) _� .�'i'�*�._ . . . . ._ � . _. _. ._si:;j '"{':�� _._ .: ._ ... .. - •1 -— ��:�'" _�:'�i..�_..�`t,���t�t��,.7 �����4Y� �'i�f��.,��.� S _� . _._T"t�f�. :. .. .e�_E.. 1.'� :'"���'-�iC. 3 t"��" .v.._. _.�`3€"!"t�..�£��3"'r���L• ,_µ :=;�'�,�I�=I E� �#�� �,�.�i�E�:f= T►�r G�� ��.�.. j.��:�1�1�. �td '��'�Z�.:'�` t�:i�►i��'�,.��i��.__�. `��I�'!� :A►.,..�. ���*'Y }�� ���;�,t�i� ����;�i I���t��:E�� �t�C� :R T€�T� �i�� ��I���'�!�==,t��"�a ���.���..� i �:��; �.�.`��� �`���L�I����:��T=�. . l_ .� ���'��C� �-�� � APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE k � � �� �� c ; .� CI�'Y OF ORONO APPLICATION FOR PLUMBING PERMIT Box 66 (2750 Kelley Parkway) Crystal Bay, MN 55323 GENERAL INFORMATION $ �'4�`�� 1. You may apply for plumbing permits by mail or in person at the City offices. AuG � �� 2. Permit cards will be sent by retum mail after a review is completed. PERMITS ARE NOT VALID ' UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTTL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Plumbing pernuts may be issued ONLY to licensed plumbing contractors and to property owners residing in the dwelling. 4. When any new construction or remodeling is involved, a separate building permit must be obtained. 5. All work must be done in accordance with the State Code requirements. 6. All work must be inspected ann air tested betore i�is cavered. Caii �+i3'357. �;-:cu;nct:ce :�qu::ed. Instructions Complete all items on this application. Compute the permit fee. Sign and date the certification. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions, call 473-7357. Please check one: New Addition Repair Replace �_ Residential Commercial JOB SITE: ���' :SU��S�� /�. Zip: Owner's Name: Telephone Number: Mailing Address: City: Zip: Contractor'sName: , �i�c I elephoneNumber: MailingAddress: � � `���`��3�Zip: 14672 Sum� r Savage, MN 5537P S SFIXTURE SCHEDULE FIXTURE BSMT 1ST 2ND OTHER FIXTURE BSMT 1ST 2ND OTHER TYPE FL FL TYPE FL FL Water Closet Fioor llrains Lavatory Sewer Ejector Bathtub Laundry Tray _ Shower Washer Kitchen Sink Water Heater Disposal Water Softener Dishwasher Wet Bar Sillcocks Misc (list) �� ;:�. � � L� � ����L I :a��Q � y� :2.ITllEII�TSS��uE�tiddd � '"h ' R v ,� �d •l�a.uo� pu� anz� `a�aiduio� az� uot���tidde siu� uo ap�ui s�uauza��as ij� ��u� sai�t�.za� pu� `��osauuiy� 3o a���s aul �o suoi��jn�a.z au� pu� �i� a� �o sa�u�ulp�o au� u�im a�u�p.zo��e ��t�as ui xzonn iI� oP o� saa.z�� `�iuuad �utquznld � 3o a�u�nsst so� �11� au� o� saijdd� �qa.�au pau�isiapun au,I, •a�ud aui io� sa�►n.ias �uot��adsul 30 1IIauzuedaQ au1 ti�� 000`000`t$ iano suoiaEnTen io,� •ialeai� st lanau�tun� - OS'� i� 000`000`t$ iapun a�tid a��i�uo� a�1 �o 5000' Si �J2IdH�2If1S �.L�'.LS au.L ** •a�Eiluo� Ien1�e aua 30 ,Cdo� pau�is �3o uotssnuqns aul lsanbai �CEtu �Cai� aq1 `�so�qof au13o�unotuE atp uo a�ndsip�si aia��1Eq1 aIIana aq1 uI �sasod.md aa3 aiuuad io� a�ud 1�Ei1IIo�io �so� pareunxsa a�1 oa pappe aq isntu sLua�i q�ns�o an�n �aX�ui aiqzuoseai aq1 �d iaulo �iue io ausnal `iaun�o aq1�Cq paqsru.m3 a�uoilE[[e�suz io 'ioqEi `luawdinba `�uatecu nu�31 'auup xiom a�1�a3 lainalsn� a�1 0� pa��q� aq o1 1IInou� a� st lI 's1so� paxg iaulo pu2 `1i�oid `SOqEj `s�eua��ui �utpni�ui xion� pa11?�.�ad aul io3 pa�ieq�lunouie�II�P Pa�E�i�sa Jo �ro�e aql suEauz.LSO�gOf i�3�I2Id .L�d2�.Li�IO� * �.k� ' �. $ (anoqE £-j sauii PPd) ��d ZINRi�d 'Id,LO.L 't� OS'T $ (suoi���iidd� ut-ii�ui �iiup) uijpu�H pue a e�sod '£ .za��a.�� si ianau�iqm `OS'$ i� (a�ud a�ei�uo�) p 5 ` $ 5000' X ��tuuad u�za o� a�i�u�zns uotsiniQ apo� �uTpimg a���s au� PPd �x* 'a .�eu�.�ns a��1s 'Z (a�ud 1��Iiuo�) 2p ��� $ SZIO' X 00'S£ aa3 aunu��uiy� .zo ,�a�t.zd ���i�uo� 30 ��SZ'i "T I�[f}I.L�'Ifl�'I�� �� ,LIL�I2I�d t ,