Permits - Permit# SP16-007 - 2401 Black Lake Road - 1/1/2016FEB 18 REVO
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CITY OF SPRING PARS
4349 Warren Avenue Spring Park, MN 55384
Noise Ordinance In Effect:
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Phone 952 471-9051 Fax 952 471-9160
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Monday - Friday
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before 7 a.m. and after 10 p.m.
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PLUMBING PERMIT
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Weekends/Holidays
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before 7 a.m. and after 8 p.m.
DATE: I a ICo P-M # 4-117- .73 —4/9- O/8S
PM No.
Pipelayers Card No.
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SITE ADDRESS: ay 01 g I O.CL- LoMe R d
OWNER Kyle- Gierinl3
PLUMBING CONTRACTOR Name / Address / City / State / Zip / Daytime Telephone
ESTIMATED VALUE
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500
CLASS OF WORK: ( ) New ( ) Addition ( ) Alteration ( X Replace
TYPE OF WORK: XResidential ❑ Commercial
Water Closet (Toilet) Bathtub
Roof Leader -Rainwater
Lavatory (Wash Basin) Shower
Drinking Fountain
Kitchen Sink & Disp. Dishwasher
Lawn Sprinkler System
Water Heater' Clothes Washer
Water Meter
)(Gas ❑ Electric Water Softner
Water Connection
Ice Maker Line Piping/Treating Equipment Sewer Connection
Rough -in Future Fixture Floor Sink or Drain
SAC
Vacuum Breakers Sump
Plumbing Comments:
Fixtures @ $5.00 each': $
gepjace gas L.JOL}er.
State Surcharge: $ /OCR
he-aler
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Total PLUMBING Permit: $ rJI ,.(}('o�%�r
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Minimum Fee of $56 00 1"8
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Signature of this application by the legal property owner ora licensed contractor, as the owner's representative is required and authonzes the City Zoning Administrator or designee and the City Building official or designee to
enter upon the property to perform needed inspections. Entry may be without prior notice. I hereby acknowledge that I have mad this application and stale that all information is true and conecl to the best of my krwwtedge. I
further agree that all work performed will be in accordance with approved plans, specifications end conditions and to abide by all ordinances of the City and the laws of the State of Minnesota regarding actions taken pursuant to
INS permit. I agree to pay all plan review fees even if I choose not to proceed with the work. Permit expires when work is not commenced with 180 days from date of permit issued, or if building and work is suspended,
abandoned or not inspected for 180 days. Work beyond or without a permit or inspection will be subject to a penalty.
Call MNSPECT for inspectlons 7520. (24 Hour Notice) 8:00 a.m. - 4:30 p.m.
SIGNATURE OF APPLICANT:
DATE:
PRINTED NAME:
DATE:
For All Rough -In And Final Inspections Call MNSPECT At (952) 442-7520 (24 Hour Notice)
For Sewer/Water Inspections Call City Hall At (952) 471-9051
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