HomeMy WebLinkAboutLA106203 PERMIT
City of Lakeville Permit Type: Plumbing
20195 Holyoke Ave Permit Number: LA106203
Lakeville, MN 55044
(952) 985-4440 * L R 1 0 6 2 0 3
www.ci.lakeville.mn.us Date Issued: 06/04/2008
Site Address: 16344 Elm Creek La
Lot: Block: Addition:
PID:
Use: 16346-48-50-52-54-56-58-60
Description:
Sub Type: Miscellaneous
Work Type: New
Description: Meter for Lot 3, Block 1
Meter Size Meter Twe Manufacturer Serial Number Remote Number Line Size
2" Compound Invensys 68246941 61994942
Comments:
Fee Summary: Description Amount Revenue Code
No Charge $0.00
MXU $130.00 7600-5163
Reducing Valve $3 t 5.00 7600-5165
Water Meter $1,550.00. 7600-5161
Total $1,995.00
Contractor: -Applicant - OWner:
Genz Ryan Plmbg & Htg
2200 West Highway 13
Burnsville MN 55337
(952) 767-1000
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 Is ued :Signature
PLUMBING PERMIT APPLICATION office vse only
~ 2~~
~ CITY OF LAKEVILLE Permit Number
~ \ BUILDING INSPECTIONS DEPARTMENT
i ~ 20195 HOLYOKE AVENUE Received B
~ LAKEVILLE, MN 55044 y
i
952-985-4440
vs~~~w.ci.lalceville.rnn us ate Recei~
DATE / ` / Y~O`U~R E-MAIL ADDRESS
SITE ADDRESS ~ CC ~ ~y~ C_..-~~~~y( ~h~p ~ ~ ~y~'..,.
'T`ENANT SUITE NO.
THE APPLICANT IS: ? RESIDENT OWNER ? CONTRACTOR
NAME
RESIDENT OWNER ADDRESS
C1TY STATE ZIP
DAYTIME PHONE # WHERE YOU CAN BE REACHED
COMPANY NAME ~,x~i, LICENSE #
ADDRESS
CONTRACTOR CITY Zt;,Lyc.,d,uU~'~l STATE ` ZIP
OFFICE PHONE # FAX #
CONTACT NAME PHONE
COMMERCIAL ONLY RESIDENTIAL ONLY
? COMM PLMBG SYSTEM GLAWN SPRINKLER ? INSIDE PLBG
PERMIT TYPE ? COMM/MULTI-FAMILY ? WATER SOFTENER CONVERSION
LAWN SPRINKLER ? WATER HEATER ? ADDN/REPAIR
? FIRE SPRINKLER ? MISC
? RPZ (Available on-line) Residential Permits Available on-line
? NEW ? ADDITION ? ALTER /REMODEL
TYPE OF WORK
? REPAIR ? REPLACE ? DEMOLITION
JOB DESCRIPTION Z~-~eL f ~ ~
RESIDENTIAL FEES:
Repairs/Remodel or Water Heater $40.00 (39.50 + .50 surcharge) Water Softener $20.00 (19.50 + .50 surcharge)
COMMERCIAL FEES:
JOB COST: $
Example: $12,000 Job Cost
~ I -I /2% of contract cost up to $10,000 and $10,000.00 x 1.5% _ $150.00
1% of cost above $10,000 plus surcharge. + $ 2,000.00 x T% = 20.00
(Surcharge =Contract Cost x .0005) + $12,000 x .0005 = 6.00
TOTAL = TOTAL $176.00
Minimum of $40.00 (39.50 + .50 surcharge)
~ NO. OF METERS SIZE OF METER LOCATION OF METER
I hereby apply for a plumbing permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Lakeville and with the Minnesota Plumbing Codes; that I understand this is not a
permit but only an application for a permit and work is not to start without a permit; that the work will. be in accordance with the approved plan
in the case of all work which requires review and approval of plans.
NAME OF APPLICANT (Please PrittFf ~Z~.~( C~4? Date "
SIGNATURE OF APPLICA )
PLEASE NOTE: SEP.?,RATE PE 'biiT A RE(~C .~1N1' BtIILIlEVG,1tiIECHANICAL S: ELEC`I'A1CAL Vi'URIi_ ~