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HomeMy WebLinkAbout1992-004190 (plumbing) PERMIT CITY OF ORONO PERMIT TYPE: �_; �};:;�;�;�,;t� 1335 Brown Rd. South • P.O. Box 66 • ` Permit Number: t:,t::s i'=-t=::i Crystal Bay, Minnesota 55323 Date Issued: t���°r';�;:�=�� (612) 473-7357 SITE ADDRESS: i�, � �.:_ =�; �.:y`r �i I r+�s� �.s�3 �°_�4*F r'� . � . �M . � 2�y�1 �.`� s.._ _..�{."��4�5�_il". 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I s_;r;_i_�i•3a_S �_arZ�,t} ��.��-ii 3�..�_:� .*���1�1 ._�t}}: E� .. :"t J. . ...._ _ i�. a 4._ L � � ___ . ..___..- — ------ ���%'ry� ---}— APPLICANT'PERMITEE SIGNATURE ISSUED BY StGNATURE J • 'CITY OF ORONO APPLICATION FOR PLIIMBING PERMIT Box 66 (1335 So Brown Rd) Crystal Bay, MN 55323 .. ��( �� *************************************************************************�* iGeneral 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 yon receive a permit card. 4. Work must not begin unless the permit card is available on the si e ';-���; 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 8one in accordance with State Code requirements. 8. A1 1 work must be inspected before it is covered. Call 473-7357. 24 honr notice reqnired. *******************r*************�**********I******* *********************** JOB SITE ADDRESS: ly'�`; �G�-1 �,�,�-G�z _��l . ��<<,�lr�x',r�i� 1^t"��'1.�,,� �-�;�;�ti � , Occupancy Type: �c Residen ial � Commercial � OWNER'S NAME: Phone No. : Mailing Address: City: /� C'�_._ � , , CONTRACTOR'S NAME: '�(�1� ����(�`rZ�I��y��`�� c�l �;r'a�� Bus. No. : - �'j'�� � � I � _,�- c � Mailing Address: 1�--1��C>1 � c`\r, ��=1�0.� �-rity: (�-�!�, Zip:�_;_,i�`� Master Plumber's State License No. : '(Y��'�1��� City Cert. No. : *************************************************************************** PLIIMBING FIXTURE SCHEDIILE (Show number of fixtures of each type on each floor) FZXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER ,------------- ---- _-�---- ---T----- ---- ------------- ---- ----�---- --------- ----- V7ater Closet Sewer Ejector _____________I____)__ _�____ ____ ____ ______ _____________ ____ ___._____ _________T_____ La�atory � � I � Laundry �ray � t�,� -------------�----�---—---- -------- ------ ------------- ---- ---•----- ---------�----- X � 1j� Bathtub � � � Washer / �� -------------�----=-- ---- -- --- ------ ------------- ---- ---^---- --------- ----- -� Shower � � Water fieater --------------�---- --•----- ------- ------ ------------- ---- --�----- --------- ----- I � Ritchen Sink j Water SoftnerI ------------ --- � ----- -------- ----- --------------+---- -------- -------- ----- _ --•- - - - - - Disposal Wet Bar -------------1---- ---- ----- ----- ------------- -- ---.---- --------- ----- Dishwasher �- S�A P�P ------------- ` ---- ----•--- ---------- ------ ------------- ---- ------- ---------- ----- Sillcocks I Misc. (List) ------------- —•--- --------- - - — - --- ---- ---------- Floor Drains _�_____�______I_____________ ____ ________ ____ _____________I=====I==_____ _ ______ ______ _____ *************************************************************************** 1. Fixture Fee The minimum permit fee is $30.00 $ ���, C� �+ Compute number of fixtures � x $8/fixture x $5/fixture reset 2. State Surcharge $ .501 :\ 3. Postage � Handling (Only mail-in applications) $ �.50 � 4. TOTAL PERMIT FEE (add lines 1-3 above) $ � - _ "�,t;--�� �rr��. *************************************************************************** The undersigned hereby applies to the City of Orono for issuance of a Flumbing Permit, agrees to do all work in strict accordance with the ordinances of the City and the •regulations of the State o£ Minnesota, and certifies that all statements made on this application are complete, true and correct. �%J Signature of A�plicant: / �1� (r.(/�/J���'� Date: '���� - ��, �