HomeMy WebLinkAboutPlumbing Permit 08-1011
DATE TIME
CITY OF PRIOR LAKE 'Mo'f
INSPECTION NOTICE SCHEDULED
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ADDRESS ,~t fJ
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OWNER CONTR.
PHONE NO. PERMIT NO. l?-lo1/
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o FOOTING o PLUMBING RI o EXIGRAD/FILLlNG
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL o GASLlN1f~ST
o SITE INSPECTION o MECH FINAL JtL )cJ:.f" ~
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COMMENTS:
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\.fi WORK SATISFACTORY, PROCEED
I;CORRECT ACTION AND PROCEED
o CORRECT WO~OR REINSPECTION BEFORE COVERING
InSpecto-f} I 'I / Owner/Contr:
CA~I1850 F~ THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue Fik:
2. Gold City'
3. Yellow Applicant
PERMITNO'8 /0/ / \
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(Please type or print and sip,n at bottom)
ADDRESS
55) ~ '&~Lnty
ZONING (office use)
B-t- - (SE
LEGAL DESCRIPTION (office use only)
Ch::>mr'nn
6!'" .3'35 131')
(Address) 3370 Do ',,':rl 1:1 n"
(Contact Pernon) F8M~s~;)i~J~ ~~~:~)
APPLICANT SIGNATURE .. r-f/~ DATE_c-J2 -lV -Of)
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (1 or 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
LOT
OWNER
(Name)
(Address)
APPLICANT
(Name)
Quantity
BLOCK
ADDITION
PID
Clr)r! \.l)~():)/r
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(Phone) q 5 J. . '-/40 -/ ( 2!5
fy) ^-/ ,. 5 5,31:1 '
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Itr/()i LLl~!
(Phone)
(Zip Code)
Type of Fixture
Rough-ins
Water Heater
Water Softener
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $49.50 minimum Residential, New One & Two-Family $149.50
Residential, Additions & Alterations $49.50
(Office Use Only)
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOT AL PERMIT FEE $
JR 50
.50
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Buildin!! Official
Date
Paid
50.00
Date
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. ~e?iPtNo51 f G,-,
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This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372