HomeMy WebLinkAboutNo 11755
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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.,:'
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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
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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.
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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: ~ /