HomeMy WebLinkAbout1991-003780 - plumbing fERMIT
CITY OF ORONO t PERMIT TYPE: F . �: NG
1335 Brown Rd. South • P.O. Box 66 Permit Number: �a?' :��.
Crystal Bay, Minnesota 55323 Date Issued: 06/25/= 1
(612) 473-7357
SITE ADDRESS:
22702 WALTER':: P13RT LA
LSV
P. I .N. : 2,1-117-23-23-00r39
DESCRIPTION:
Plumbing Permit Type FIXTURES
Plumbing Werk Type. REPLACE EXISTING
I BATHTUB I LAVATORY/RI
REMARKS:
FEE SUMMARY:
i
Ease Fee $30.00
Surcharge ----------1_,Q
Total Fee $30. 60 CITY OF OMWO
Iasi:�6h44CE OFFICE #
01 GEN 30.4p
1.12,17.21V0000 #
CHECK,41 TL N 3O.5
RECEIPT-THAW YOU
t 16 O CON R01 T14:40
06125191
CONTRACTOR: pWNE(�: -- App 1 i c ant• --
i� OTT ANDREW
702 WALTER: FORT LA
ORON13 MN 55331
(612)471-9898
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a _ F E_R r:!I'�S I._!N T!_! MA `.r TH. RENAL IMPROVEMENTS*
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_ AANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
CITY OF ORCNO APPLICATION FOR PLU2BING PERMIT
Box 66 (1335 So Brown Rd)
Crystal Bay, MN 55323
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 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 separate building permit must
be obtained.
_ 7. All work must be done in accordance with State Code recruirements.
8. All work must be inspected before it is covered. Call 473-7357.
24 hour notice required.
JOB SITE ADDRESS: ), 10 VJ 0"i.., E_ C'> F 0-=i
Occupancy Type: Residential Commercial t�
OWNER'S NAME: 0 ua �"' _ Phone No. . r1 1 Z,)C�
Mailing Address: ` V�_-V City: [ n.a
CONTRACTOR'S NAME: �(�t F-�I �
8Us.� No. : - 1 2,S
Mailing Address: City: Zip:
Master Plumber' s State License No. : City Cert. No. :
PLUMBING FIXTURE SCHEDULE
(Show number cf fixtures of each type on each floor)
FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER
-------------7--- ----- --- - ----^---- ---- -----
T----- - r
P:ater Closet I ---- Sewer Ejectors _-- i
_____________ -- ____i____ I_----- _____________ _ -------------------------
Laundry
__._-___ ___-__________-
Lavatory---- --- ' -------I - ---1------Laundry---al- �--- ' -- ----- ---------I -----
_ _ _
Bathtub I j I � Washer _1_ i
-----------=-------y-- - ------ ------------- I--- � ------- ---------r-----
Shower i Water Heater
------------- i-------- -------------------- -------------------------- -
Water -
--------i-----
Kitchen Sink i ------------i----
1-------- ---------I-----
-------------- --
------------7-- ----------- -
Disoosal IWet Bar
-------------y---- ----- ------- ----- ----+------- ---------�------
-
Dishwasher ! Sump-----Fu------- ---- ---
mp
1
-- ---- ------ ---_----_---- --- - ----------------
Sillcocks ----� Misc (List)
Floor Drains
-------------1---- --- ---1-
------------- -----�-------- --------- ------ ------------- ---- -------- ---------- -----
1. Fixture Fee The minimum permit fee is $30.00 $
Compute number of fixtures 1 x $5/fixture
x $3/fixture reset
2. State Surcharge $ .50
3 . Postage & Handling (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (add lines 1-3 above) $
***************************************************************************
The undersigned hereby applies to the City of Orono for issuance of a Plumbing Permit,
agrees to do all work in strict 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 orr t.
Date:
Signature of Applicant:;