Permits - Permit# SP12-001 - 2413 Black Lake Road - 1/1/2012CITY OF SPRING PARK
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4349 Warren Avenue Spring Park, MN 55384
Noise Ordinance In Effect:
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Phone (952) 471-9051 Fax (952) 471-9160
Monday- Friday
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PLUMBING PERMIT
before 7 a.m. and after 10 p.m.
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Weekends/Holidays
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before 7 a.m. and after 8 p.m.
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DATE: { — J `��
PM No.
Pipelayers Card No.
SITE ADDRESS: Z�
OWNER�V
PLUMBING CONTRACTOR NpUle / Adtlress i / State / Zip / Daytime Telephone
ESTIMATED VALUE
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# 61776-PM
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3670 Dodd Rd.
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I1.1-^00 Ur vvUMK: ( ) New--'-(' " ') Aaditlon ( ) Alteration ('-(-q Replace I
TYPE OF WORK: 43 Residential ❑ Commercial
Water Closet (Toilet)
Bathtub
Lavatory (Wash Basin)
Shower
Kitchen Sink & Disp.
Dishwasher
Water Heater
Clothes Washer
❑ Gas ❑ Electric
Water Softner
Ice Maker Line
Piping/Treating Equipment
Rough -in Future Fixture
Floor Sink or Drain
Vacuum Breakers
Sump
Roof Leader -Rainwater
Drinking Fountain
Lawn Sprinkler System
Water Meter
Water Connection
Sewer Connection
SAC
Plumbing Comments: { Fixtures @ $5.00 each': $ 6,00
State Surcharge: $ .50
Total PLUMBING Permit: $ 5CE LL
'Minimum Fee of $50.00
Signatureof this applu,shon by the legal property owner or a licensed contractor. as the owners representative is required and authonzes the City Zoning Administrator or designee and the City Building Official or designee
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 [me and correct to the best of my knowledge. I further agree that all work performed will be in accordance with approved plans, specifications and conditions and to abide by all ordinances of the City and the laws of the Slate of Minne;ola regarding actions lek— pumusni io
this peril. I agree to pay all plan review fats even :f I choose not to proceed with the work. Permit expires when work is not commenced with 180 days from dale of peril issued, or if building and work is suspended,
abandoned or not inspected for 180 days. Work beyond or without a perll or inspection will be subject to a penalty.
Call MNSPECT for inspect' sat (952) 442-7 0. our 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