HomeMy WebLinkAbout1987-000533 - plumbing PERMIT -
���ONO PERMIT TYPE: �;�;�;���;�;��`�
South • P.O. Box 66 Permit Number: i;i,�;s;�;;;;;
C;rystal Bay, M�nnesota 55323 Date Issued:
(612) 473-7357
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APPLICANT/PERMITEE SIGNATURE ISSUED BY: NATURE
INSPECTION RECORD
CITY OF ORONO PERMIT TYPE: �'�-�'���z���
1335 Brown Rd. South • P.O. Box 66 Permit Number: i'{�{'�•=='
Crystal Bay, Minnesota 55323 Date Issued: ��`'�ty�=��r��
(612) 473-7357
SITE ADDRESS: APPLICANT:
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NO t ,�,�� APPLICATION FOR PLIIMBING PERMIT
35 So Brown Rd) �
3ay, MN 55323
,. ..�*.. :K******************************************************************
' t�eneral 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.
Permit cards will be sent by return mail the same day the application is received. `
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3. Permits are not valid until you receive a permit card.
4. Work must not begin unless the permit carc�: 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. A1 1 work must be done in accordance with State Code requirements.
8. All work must be inspected before it is covered. Call 473-7357. 24 hour notice
required.
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JOB SITE ADDRESS: 353� � y�l/�
Occupancy Type: Residential Commercial
OWNER'S NAME: � �� ����� Phone No. . / l � —</D�/
Mailing Address: ��� City: �Z T�
! CONTRACTOR'S NAME: � U(�' j �i-G'i 7�� (� Bu s. No. : 5�1��C
Mailing Address: 5 ��___ _ City:
Master Plumber's State License No. : City Cert. No. :
***************************************************�***********************
PL01�4BING FIXTURE SCHEDULE
(Show number of fixtures of each type on each floor)
FIXTURE TYPE BSMT 15T FLOOR 2ND FLOOR OTHER FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER
Water_Closet -�-- --------- -------- ----- -Laundry TraY- ---�--- ----- -------- ----
� Lavatory / ---_ Washer !
------------- -{--- --------- -------- - -------------- -------- ----- -------- -----
Bathtub , Water Aeater
------------- ----- --------- -------- ----- -------------- --------
Shower Water Softner
; Kitchen_Sink- --�-- --------- -------- ---- Misc�-(list�- -------- ----- -------- -----
Disposal
; ------------- ----- --------- -------- ---- -------------- -------- ----- -------- ----- ;:
Dishwasher
Wet Bar
------------ --- -------- -------- --- -------------- -------- ----- -------- ----- �
Sillcocks
------------- ----- --------- -------- ---- -------------- -------- ----- -------- ----- ;
; Floor Drains s
------------ � ------- ------- --- -------------- -------- ----- ------- ----- a
Sump Pump
-0 sewer Ejector
******************************** ******************************************
1. Fixture Fee The minimum permit fee is $30.00 $ 3 Z-•�(�
Compute number of fixtures x $4/fixture #
�
2. State Surcharge $ .50
3. Postage & Handling (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (add lines 1-3 above} $ j� � � �
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The undersigned hereby applies to the City of Orono for issuance of a Plumbing Permit, r
; 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 a co ect �y�� .
g PP �,� �� X ___ __... ,
Si nature of A licant: �j '�� Date: �' �