HomeMy WebLinkAboutLA107556 PERMIT
Clty Of LakeVllle Permit Type: Plumbing
20195 Holyoke Ave Permit Number: LA107556
Lakeville, MN 55044
(952) 985-4440 * L A 1 Q1 7 5 5 6
www.ciaakeville.mn.us Date Issued: 08/22/2008
Site Address: 16367 Elm Creek La
Lot: Block: Addition:
PID:
Use: 16369-71-73-75-77-78-81-83
Description:
Sub Type: Miscellaneous
Work Type: Alter/Remodel
Description: Meter for Lot 2 Block 2 Fieldstone Creek 3rd Add
Meter Size Meter Tune Manufacturer Serial Number Remote Number Line Size
2" Compound InvenSys 69566654 63257587
Comments:
Fee Summary' Descri to ion Amount Revenue Code
Water Meter $1,550.00 7600-5161
Reducing Valve $315.00 7600-5165
MXU $130.00 7600-5163
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.
i
Applicant/Permitee: Signature Issued By: Signature
PLUMBING PERMIT APPLICATION Office Use Only
' ~ \ CITY OF LAKEVILLE Permit Number
~ BUILDING INSPECTIONS DEPARTMENT
~ ~ , +1 .20195 HOLYOICE AVENUE
~ ~ LAKEVILLE, MN 55044 Received By
952-985-4440
~~~vw.ci.lakeville.n~n.us bate Received
DATE YOUR E-MAIL ADDRESS
SITEADDRE}SS j~ C~~~e_~c 1 ~
TENANT 1~C? L 2? (`k' Z.. t-' j
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t'~~:~~~ Yl ~ - St:~ ~l'f
THE APPLICANT IS: ? RESIDENT OWNER ? CONTRACTOR
NAME
RESIDENT OWNER ADDRESS
CITY STATE ZIP
DAYTIME PHONE # WH/ERE YOU CAN BE REACHED
COMPANY NAME (r--~~ ~ LICENSE #
ADDRESS L
CONTRACTOR CITY STATE ZIP
OFFICE PHONE # FAX #
CONTACT NAME .PHONE
COMMERCIAL ONLY RESIDENTIAL ONLY
? COMM PLMBG SYSTEM ? LAWN SPRINKLER ? INSIDE PLBG
PERMIT TYPE ~ COMM/MULTI-FAMILY ? WATER SOFTENER CONVERSION
LAWN SPRINKLER ? WATER HEATER ? ADDN/REPAIR
? FIRE SPRINKLER ? MISC
? RPZ (Avallable on-line Residential Permits Available on-line
? NEW ? ADDITION ? ALTER /REMODEL
TYPE OF WORK
? REPAIR ? REPLACE ? DEMOLITION
i t ~1 f , f
JOB DESCRIPTION F'~ (.....~~fYL~-J G~/,~L~a ~~"1 ~'~f'i`'_ ~~U
RESIDENTIAL FEES:
Repairs/Remode] 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
1-1/2% 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 1% = 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 Print) ' ~ Date ~ ZZ d
SIGNATURE OF APPLIC
PLEASE NOTE: SEYAR.4TE PE TS REQUIRED ' I3LIILDING. MECHANICAL ~ ELb;CTAICAL WORK