HomeMy WebLinkAbout1991-003996 - water softner �,� �_�,� �� , :, �. � �'ERMIT
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1335 Brown Rd. South • P.O. Box 66 i;��i;'���,�,"�`�
Permit Number:
Crystal Bay, Minnesota 55323 Date Issued: '�`-�`�`-''_'��_��
(612) 473-7357
SITE ADDRESS: _ _
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE �.G��
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� CZTY OF ORCNO r�PPI,IC�TION �OR PI,U.�BING PERMIT
! Box 66 (1335 So Brown Rd)
Crystal Bay, MN 55323 � �`J��j
***************************************************** * ** ****************
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 handling fees shown below.
Perr.iit cards will be sent by return mail the same dal the application is received.
3. Perm.i.ts are not valid until yon receive a permit cazd.
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 requirements.
, 8. All work must be inspected before it is covered. Call 473-7357.
24 honr notice reqnired.
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JOB SITE ADDRESS: l7S�T �� �rE/r/�IES /Do/�T �✓ �
- Occupancy Type: Residential Commercial `
OWNER'S NAME: p.4 �t G� �•4L�s/N/ Phone No. : N7/ � ��90
Maiiing Address: /7K c� cc,/«Go � d�'� City: o�a� oY0
CONTRACTOR'S NAME: G cc H c./ r�i-A-rV Bus. No. : Q �i 3= 7 �a a
Mailing Address: 60?�� cu�.�iG-�n� r.v��-,,� City: ,�,T-�« Zip: ,}-�-31s-
Master Plumber's State License No. : City Cert. No. :
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- - PLIIMBING FIXTIIRE SCHEDIILE
� (Show number of fixtures of each ty�e on each floor)
_ FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER FZXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER
---^---�----- ------ ------------- ---- --------- --------r
------------- -T----- .
� r Sewer Ejector � i
P:ater Closet � i
_____________1____�________�__ _ ____I______ _____________ ____ ___._____ _______________ F
Lavatory � ' I i Laundry Tray � �
Bathtub -----i---- �—i --—----�-------- -------washer------- �---- ---•----- ---------I -----
-------------�-------------i-- --- ------ --------------�----1-------- ---------r-----
� i , I Water fieater i
.., Shower _____
- ' ' -•-------------- ------ ---- ---•----- ---------�
---------------------- :
, X� � Ritchen Sink ; ; I Water Softner�_ I_ �_ ,
_ - ---------------------------- ------- ------�------------- ---�1 -------- --------I----- �
�- ;
Bisposal Wet Bar I
I ;
�------�------- ------ ------------- ---- ---•---- ---------i-----
-------------1-----� .
� ' Sumo Pump
Dishwasher I i
' ------ ------------- ---- ------- ----------� ----=-
---------- 1-----�----•--- ,---------
Sillcocics � � � Misc. (List) �
-------- -----� ------------- ---- --- -----
---- ----•--- - ---------- _
------------- -
----
� Floor Drains � '
----- ---�---- --------- ------ ------------- ---- -------- ---------- -
*************************,t************,t************************************ �
1. Fixture Fee The minimum permit fee is $30.00 S 3 a � a� ; f
Compute number of fixtures x $5/fixture '�
- x $3/fixture reset
I2. State Surcharge $ 'S0 '
�
- 3. Postage & Handling tOnly mail-in applications) $ 1.50 :
. . �
4. TOTAL PERMIT FEE (add lines 1-3 above) $ �a-m d �
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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 correct. �
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� Signature of Applicant:�� � � � ' t ����- ��'� l.;,-__ . _ Date: �� �%�% ��/ �i
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