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State State State State [ ] Commercial [ ] Residential Fee Qty Total Fee Qty Total General Requirements Other Plan Review Rough Underground Date (Continued on Reverse Side of this Document) Applicant Signature Grand Total Credit Card has a 3% Surcharge Water Supply/Distribution 6" Water Supply/Distribution Permit Information Sanitary Drainage 6" Special Piping/Storage Systems Fixtures/Faucets/Fixture Fittings Final Sanitary Drainage< 6" Storm Drainage < 6" Storm Drainage 6" Indirect/Special Waste Water Supply/Distribution < 2" Traps/Interceptors/Separators Vents Water Heaters Item Description Item Description Application Fee INSPECTIONS Application Fee (Extension) Enforcement (working without permit) Plumbing Systems Category Information Plumbing Fee Schedule SCOPE OF WORK TO BE COMPLETED [ ] Alter [ ] Enlarge [ ] New [ ] Repair Contractor License Name License # License Expiration Date Email Address Zip Code Permit Application - Plumbing Otsego County Land Use Services Department Phone: [PHONE REDACTED] 1322 Hayes Road, Gaylord MI 49735 Fax: [PHONE REDACTED] www.otsegocountymi.gov Permit Property Information Applicant Information Address City Zip Code Owner Phone # Cell # Email Address Property Owner Information Address City Zip Code Address City Zip Code [ ] Contractor [ ] Owner Phone # Cell # Email Address Address City Print Reset 35 1 35 85 0 4 0 4 0 8 0 20 0 39 0 8 0 20 0 4 0 4 0 4 0 8 0 20 0 39 0 170 0 50 0 50 0 50 0 50 0 50 0 50 0 SIGN 35