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HomeMy WebLinkAboutNo 11755 e City of Lakeville .t9 PLUMBING PERMIT Permit Fee.......... pp~~ T State Surcharge . Q( RECEIP 1 TOTAL FEE PAID... `t~•~ Permission is hereby granted to ~9~tthew ~~n~P<- rtcl~~c 1'oiaztr,=, 3rd Add:iti,ax~ Building on Lot No. Block ~ Subdivision Parcel No. ~"_.dn tn~~_fy~r:_.t.,:' ` z:, In the CITY OF LAKEVILLE to be used as ` ; ~ t = ' ' ` x i' i,xs ~i~ ~n~ ~ 4-+'i'~ s ~ rtac; L ~cn This permit is issued on the express condition that the ERECTION ALTERATION REPAIRS ty INSTALLATION MOVING DEMOLITION respects to the statements certified to the application for such permit, and that a1F work shall be done in accordance with the Ordinance of LAKEVILLE, Minnesota and the State of Minnesota pertaining to the construction of buildings. Street Address lt;~f.i~.m~L•'z~ei i•3~ti* ~1.~r~rt 1J~~,:ar' Director, License and Inspection P BY j" - Attention is particularly called to the cutting up of streets, making main sewer connections, driveways and curbs. Obtain permit for such construction from the CITY OF LAKEVILLE. Inspection Department Not Responsible For Any Damages to Public Utilities. Call for inspections: 469-4431. A s ~~~CR<~~ ~ C~i~t,~ 1 ~ " ~ i PLUMBING PERMIT APPLICATION CITY OF LAKEVILLE INSPECTION DEPARTMENT 8747 208TH STREET WEST, P.O. P,OX 957 LAKEVILLE, MN 55044 469--4431 DATE: JOB SITE. ADDRESS: C PID - . LEGAL DESCRIPTION: LOT: BLOCK: SUBDIVISION OR SECTION: APPLICAN`T': OWNER OR CO'ITRACTOR~~:(circle one} OWNER OR BUILDER: ~rC~ ~Z ~`~r~l~~ ~r/~%/~ PHONE: `7-~~/ -l STREET ADDRESS: ~ ~_4~lr~!;~ , v ' p", CiTY:~1~~i,,~~~~ _ZIF: ~a~ % PLUMBING CONTRACTOR:/ ~iI~~~~t.~ CITY ID NO.~~ PHONE: STREET ADDRESS: ~ ~~~ge ~ ~ / ~ - CITY: ~'~~t~~~'~r'2~ 7IP:~~C~~% T ~`~NEW CONSTRUCT ~'OR EXISTING (circle one) PLUMBING SYSTEM (2I): SOFTENER (22): SPRINKLER (23}: STANDPIPE (24}: LAWN SPRINKLER (25}: INSIDE PLBG CONV (26): REPAIR OR REMODEL (2?): FOR:. RESIDENTIAL: / ~ COMMERCIAL: INDUSTRIAL: PUBLIC: JOB COST: (commercial only) PLUMBING FIXTURES: (indicate the number installed including rough-ins) _ WATER CLOSET (O1) I FLOOR DRAIN (10} -sue LAVATORY (02) DRINKING FOUNTAIN (11) .DISHWASHER (03) SLOP SINK (12) SHOWER (04) WATER SOFTENER (13) BATHTUB {05} URINAL (14) WASHER (06) DISPOSAL 15) LAUNDRY TUB (07) RAIN LEADER (16) _ r KITCHEN SINK (08) CATCH BASIN (17} CLOTHES WASHER (09) OTHER (18) OTHER (19) APPLICANT'S SIGNATURE: DATE: OFFICE USE PLUMBING FEE RATES: Residential: Commercial; New Construction: $40.00 li of contract cast, up to $10,000 ($39.50 + .50 surcharge) and l/2i over $10,000 + surcharge (contract valuation x .0005). Repairs or Remodel:. $20.00 Minimum of $25.00 ($24.50 + .50 ($19.50 + .50 surcharge) .surcharge) Water Softener: $10.00 (9.50 + .50 surcharge) Call to have water softener inspection when installer is at property! PLUMBING PF,RMIT APPLICATION PAGE 2 OFFICE USE SYSTEM TYPE: OFFICE USE: METER: PLUMBING SYSTEM (21) SOFTENER (22} _ SIZE SPRINKLER (23) STANDPIPE (24) TYPE LAWN SPRINKLER (25) INSIDE PLBG CONV (26) _ SERIAL # REPAIRS OR REMODEL (27) - F.EM READ # WORK TYPE: NEW (81) LINE SIZE ADDITION (82} REPAIR (83) DEMOLISH (84) LOCAL CODE: REPLACE (85) ALTER/REMODEL (86) SNGL FAM RESIDENCE (131) MOVE (87) TWO FAM RESIDENCE (132) PERMIT FEE: TOWNHOUSE (133) PERMIT FEE: A~~ hiUI,TI-FAM APTS (134) 0 SURCHARGE: $ ,.j COMMERCIAL (135) METER $ INDUSTRIAL (t36) REDiJCING VALVE: $ TAX EXEMPT (137) OTHER: $ MOBILE HOMF. (138} TOTAL: ~ UNDEFINED (999) INSPECTIONS: ROUGH-IN (64) FINAL (65) (70) APPROVED BY: DATE: ~ /