HomeMy WebLinkAboutNo 11765
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City of Lakeville rx4,~~ :~,g ,,9~~=
~ ! rJ Permit Fee.......... `°~i, `~U
PLUMBING PERMIT
_ & R E C E I PT State Surcharge •
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TOTAL FEE PAID . .
Permission is hereby granted to r`~.{r;~~
Building on Lot No. a ~ Block Subdivision '~t'+=~ a
Parcel No. _ ~ 3 f~f' : a,
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In the CITY OF LAKEVILLE to be used as _ ~ ~ ~ '
This .permit is issued on the express condition that the ERECTION ALTERATION REPAIRS
INSTALLATION MOVING DEMOLITION respects to the statements certified to the application for
such permit, and that all work shall be done to accordance with the Ordinance of LAKEVILLE, Minnesota and the State
of Minnesota pertaining to the construction of buildings.
Street Address _ ~ r', t~, : ~r: c;
Director, License and Inspection
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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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FLUMBING PERMIT APPLICATION
CITY OF LAKEVILLE - INSPECTION DEPARTMENT
8747 208TH STREET WEST, P.O. BOX 957
LAKEVILLE, MN 55044
469--4431
DATE : ~
JOB S ITF. ADDRESS : I ~ ~ ~ ~ PID _ _
LEGAL DESCRIPTION: LOT: ~ BLOCK.: / SUBDIVISION OR SECTION: 3~~
APPLICANT: OWNER flR CONTRACTOR (circle one.}
OWNER OR BUILDER: PHONE : ~ _ ~ 7v? /
STREET ADDRESS: ~l~t.G~vt ~(,.z~, CITY: d.-~ ~_IIF: SS~~ ~
PLUMBING CONTRACTOR: ~ CITY ID N0. ~ ~ ~ PHONE:_~~~~? 9
STREET ADDRESS: ~ 3 ~f_~~~- CITY: ~ ~_ZIP:~~0. js
NEW CONSTRUCTI"QN~OR EXISTING (circle one)
PLUMBING SYSTEM (21): ~f_ SOFTENER (22): SPRINKLER (23): .STANDPIPE {24}:_
LAWN SPRINKLER {25}: INSIDE PLBG CONY (26): REPAIR OR REMODEL (27):
FOR: RESIDENTIAL: COMMERCIAL: INDUSTRIAL: PUBLIC:
JOB COST: (commercial only)
PLUMBING FIXTURES: (indicate the, number installed including rough-ins)
~ WATER CLOSET (Ol) ~ FLOOR DRAIN (i0}
LAVATORY (02} DRINKING FOUNTAIN (11)
% DISHWASHER (03) SLOP SINK (12)
! SHOWER{04) WATER SOFTENER (13}
BATHTUB {05) URINAL (14)
WASHER (06) 1 DISPOSAL (15)
/ LAUNDRY TUB (07) RAIN LEADER {16)
~ KITCHEN SINK (08) CATCH BASIN (17}
CLOTHES WASHER (09) OTHER (18)
OTHER (19)
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APPLICANT'S SIGNATURE: DATE: /
********************:k*#**#***~~*
OFFICE USE
PLUMBING FEE RATES:
.Residential: Cammercial:
New Construction: $40.00 li of contract cast, up to $10,000
($39.50 + .50 surcharge) and 1/2~ 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 PERMIT 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 PLBC CONY (26} SERIAL #
REPAIRS OR REMODEL (27)
REM READ #
WORK TYPE:
LINE SIZE
NEw (sl}
ADBITION (82}
i REPAIR (83)
DEMOLISH (84} LOCAL GORE:
~ REPLACE (85)
ALTER/REMODEL {86) 5NGL FAM RESIDENCE (131}
MOVE (87)
TWO FAM RESIDENCE (132}
PERMIT FEE: TOWNHOUSE {133}
' PERMIT FEE: $ MULTI-FAM APTS (134)
SURCHARGE: $ COMMERCIAL {135)
METER $ INDUSTRIAL (136)
REDUCING VALVE: $ TAX EXEMPT (137}
OTHER: $ MOBILE HOME (138)
TOTAL: $ UNDEFINED (999)
INSPECTIONS:
ROUGH-IN (64)
FINAL {65)
(70)
APPROVED BY: DATE : ~~^,1