Permits - Permit# SP14-005 - 2437 Black Lake Road - 1/1/2014W
M
CITY OF SPRING PARR
Noise Ordinance In Effect:
r-
c
3
4349 Warren Avenue Spring Park, MN 55384
1 z
Phone (952) 471-9051 Fax (952) 471-9160
Monday - Friday
before 7 a.m. and after 10 p.m.
O m O
PLUMBING PERMIT
X
ic
X
Weekends/Holidays
ii
3
before 7 a.m. and after 8 p.m.
DATE: L ` - 4-
PM No.
Pipelayers Card No.
SITE ADDRESS:
OWNER m( _,r , l.�-I+f_
PLUMBING CONTRACTOR Name / Address / City / State / Zip / Daytime Telephone
ESTIMATED VALUE
jt�n
Fb `JYw-io n+ � _ i � b Z�[�ECLt AvL- j>
q cri
�.Jwk O j/k&vl �7 �13
CLASS OF WORK: ( ) New ( ) Addition ( ;( ) Alteration ( ) Replace
TYPE OF WORK: Residential ❑ Commercial
( Water Closet (Toilet) Bathtub
Roof Leader -Rainwater
Lavatory (Wash Basin) I 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:
r7 Fixtures @ $5.00 each*: $ 5; 0
*NOTE: Commercial plans will be submited to the Met Council
•2014 SAC Escrow :$2,435 $2,485
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.
$
State Surcharg :�$5.0O�
Total PLUMBING Permit: $
*Minimum Fe_e of $50:OO—,,
Signature of this application by the legal property owner or a licensed contractor, as the owner's representative Is required and authorizes the City Zoning Administrator or designee and the City Building Official or designee td
enter upon the property to perform needed inspections. Entry may be without prior notice. I hereby acknowledge that I have read this application and state that all Information is true and correct to the hest 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 State of Minnesota regarding actions taken
pursuant to this 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 Inspections at (952) 442-7520. (24 Hour Notice) 8:00 a.m. - 4:30 p.m.
SIGNATURE OF APPLICANT:
DATE:
PRINTED NAME: -,_4
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
�i