HomeMy WebLinkAboutLA179535 PERMIT
City of Lakeville Permit Type: Plumbing
20195 Holyoke Ave Permit Number: LA179535
Lakeville,MN 55044
(952)985-4440 * L R 1 7 9 5 3 5 *
www.ci.lakeville.mn.us Date Issued: OSi12/2020
Site Address: 4984 161st St W
Lot: Block: Addition:
PID:
Use: SBF
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Description:
Sub Type: Comm/Multi-Family Lawn Sprinkler
Work Type: New
Description: SBF Irrigation
Meter Size Meter Tvne Manufacturer Serial Number Remote Number Line Size
Comments:
Fee Summary: Description Amount Revenue Code
PL-Commercial(Minimum) $40.00 1000-4152
Surcharge- $1.00 $1.00 1000.2127
Water Meter $1,090.00 7600-5161
Total: $1,131.00
Contractor: - Appti�ant - Owner:
Plumbing Restoration and Services LLC
889 Pierce Butler Route
St.Paul MN 55104
(651)253-1083
I HEREBY AGREE THAT THIS WORK WILL BE PERFORMED ACCORDING TO:(1)THE APPROVED PLANS&
SPECIFICATIONS;(2)THE APPLICABLE CITY ORDINANCES&CODES;AND(3)THE MN STATE BUILDING CODE.
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Applicant/Permitee: Signature Issued By: Signature
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PLUMBING PERMIT APPI.ICATION j ° �e Ctae�1:
P it Number
CITY OF LAKEVILLE �C����/�
BtTILDING TNSPECTIONS DEPART'MENT �-4��-�`�
' " 20195 HOLYOKE AVENUE ecerved BY�
I.AKEVILLE,MN SSO�A �j � �I �/�j1
952-985-4440 � �
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DATE 05111/2020 YOUR E-MAIL ADDRESS aneie�nlumbina-restoration.com
SITE ADDRESS 49$4 161 st St W __
TENANT SUITE NO.
THE APPLICATIT I5: ❑RESIDENT OWNER OCONTRACTflR
NA1vtE RT Urban Homes
RESIDENT OWNER ADDx�ss 16972 Brandtien Farm Drive
CITY Lakeville STATEMN ziP55044
DAYTIME PHONE#WHERE YOU CAN BE REACHED
coMPANYxAME p�umbing Restoration and Services LLLICErrsE #pC005526
CONTFtAC.TOR ADDRESS 889Q Pierce Butter Roufe �
Crnnpany name muat be as CITY $t.PBUI___...___.___.__... __ _._______. STATE MI� 7,IP 55104
appears on State License pFFICE PHONE# 651-528-8834 FAX#
CON"I'ACT NAME Ailen Steiner PHONE 6�1-233-9950
COMMERCIAL ONLY RESIDENTIAL ONLY
❑COMM PLMBG SYSTF,M ❑LAWN SPRINKLER ❑1NSIDE PLBG
❑COMM/MULTI-FAMILY ❑WATER SOFTENER CONVERSION
PEItMIT TYPE I,AWN SPR[NKI.F,R ❑WATER HEATER QADDN/REPAIR
❑FIRF.,SPRINKI,F.R ❑MISC(�11 description)
BBACKFLOW
IN3TALLATION Residentral Perrrrits Available on-tine
TYPE OF WORK �NEW ❑ADDITION ❑ALTER/REMODEL
❑REPAIR ❑REP[,ACE ❑DEMOLITION
JOB DESCRIPTION installation of Meter and RPZ for Irriaatifln in the Snirit of Brancltien Farm developmer
RESIDENTIAL FEES:
RepairslRemodel,Water Heater or Water Softener$40.�+5tata Surcharge($1.00)
COMMERCIAL FEES:
JOB COST: $500.00 Eaample:512,040 Job Cost
]-1l2%of oontract cost up to$10,000 $40.00 $10,000.Q0 x 1.5%_ $I 50.00
l%of cost above$1�,040 pius surcharge + $ 2,000.00 x 1% _ + 20.00
(Surcharge=Contract Cast x.0005) +$�y,pp �12,OOQ x.U005 = + 6.00
T�OTAL =$41.00 = $176.00
Minimum of$40.00+State Surcharge(S1.b0)
NO.OF METERS SIZE OF METER LOCATION OF METER
1 2" 1/4 mile east of Ea leview Dr. on 161 st St
I 6ereby apply for a plumbing permit and I acknowledge that the information ebove is complete and aoourate; that the wak will be in
confrnmance with tlie oidinsnces and codes of the City of Lakeville and with the MinnesMs Plumbing Codes;that I understand this is not a
peimit buY only an applicatioa for a permit and work is not to stert without a permit;that the work will be in acoardence with the epproved plan
in the case of all work whiah requires review and approval of pl�s.
NAME UF APPLICANT(Please Print)p��e tei Date 05/11/20
SIGATATURE OF APPLICANT: �
PLLASE NOTE: SEPARATE PERMITS ARB ANY BLIILDIPiG MFfiHANICAL&ELECTRICAL WORK