Permits - Permit# 11-8-12 - 2433 Black Lake Road - 1/1/201200
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CITY OF SPRING PARK
Noise Ordinance In Effect:
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4349 Warren Avenue Spring Park, MN 55384
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Phone (952) 471-9051 Fax (952) 471-9160
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.
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DATE: v
PM No.
Pipelayers Card No.
SITE ADDRESS: % 1 51-t r
OWNER ZO,—d /-[ ICIff
PLUMBING CONTRACTOR Name / Address / City / State / Zip / Daytime Telephone
ESTIMATED VALUE
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CLASS OF WORK: ( ) New ( ) Addition ( ) Alteration ( Replace
TYPE OF WORK: ❑ Residential Xcommercial
Water Closet (Toilet) Bathtub Roof Leader -Rainwater
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e� 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`: $
State Surcharge: $
'NOTE: Commercial plans will be submited to the Met Council •2012 SAC Escrow :$2,3t35 $2 365
Environmental Svcs for SAC (sewer availability charge) ,
determination. Escrow payment will be required when permit is $
issued. If after Met Council review no SAC is determined, escrow
will be refunded in full. $
Total PLUMBING Permit: $
'Minimum Fee of $50.00
Signature of this application by the legal property owner or a licensed contractor, as the "net'senta ' is required and authorizes the City Zoning Administrator or designee and the City Building Official or designee to
enter upon the property to perform needed inspections. Entry may ilhout prior notice. I ac ge that 1 have read this application and state that all information is true and correct to the best of my knowledge. I
further agree that all work performed will be in accordance wit p ed plansk , specs' nd ons and to abide by all ordinances of the City and the laws of the Slate of Minnesota regarding actions taken pursuant to
this permit I agree to pay all plan review fees even If I c se t to proceed with ork a 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 181 days. Work beyond with t a permit or ape ill auact to a penalty. _
Call MNSP T f Ins i s 44 -7520. (24 Hour Notice) 8:00 a.m. - 4:30 p.m.
SIGNATURE OF APPLIC T DATE:
PRINTED NAME: DATE:
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For All Ro h-In And Final Inspections Call MNSPECT At (952) 442-7520 (24 Hour Notice)
For Sewer/Water Inspections Call City Hall At (952) 471-9051