HomeMy WebLinkAboutPlumbing Permit 11-0069 pATE TIME
ClTY OF PRIOR LAKE
INSPECTION NOTtCE SCHEDULED L �
ADDRESS (/�
OWNER CONT .
PHONE NO. PERMlT NO. u�- QGCa �
❑ FOOTING ❑ PLUMBlNG RI ❑ EX/GRADIFILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING 0 WATER HOOKUP ❑ FIREPLACE RI
❑ lNSULATION ❑ SEWER HOOKUP ❑ FIREPLACE F(NAL
❑ FINAL ❑ PLUMBING FINAL OyGASL NE AIR T
❑ SITE INSPECTION ❑ MECH FINAL �_ �
COMMENTS:
�WORK SATISFACTORY, PROCEED
❑ CORRECT ACT N AND PROCEED
❑ CORRE CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS !N ADVANCE.
fODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETYl
wsivon
, Date Rec'd
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� �� CITY OF PRIOR LAKE PLUMBING PERMIT
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�I�'NES��P 1 Blue File
Z. Go,a �, PERMIT NO. �
3. Yellow Apphcant ✓
lease or ' t and si n at bottom
ADDRESS � � � ZONING (ofl'ice use)
�.J`� 1 �
LEGAL DESCRII'TION (oflEice use only)
LOT BLOCK ADDITION PID
�aWNER b V1 � � C��--1 (Phone) � �d � "1 " 4 � � ,�— `' v�
(Address) J�� e � � � 3
i n um n
(Name) �T # 61770-PM � (Phone)
(Address) 3670 Dodd Rd.
(Address) ' (City) (Zip Code)
(Contact Person) � C �l „J (Phone)
APPLICANT SIGNATURE DATE � � � � � '
APPLICANT PLEASE COMPLETE BELOW
Quanti T e of Fiacture Quanti T e of Figture
Bath Tub with or without shower R
Dishwasher ater Heater
Floor Drain Water o ener
Lavato Bathroom Sink Stand Pi e Washin Machine
Laun Tra 1 or 2 com artment sink Sewa e E'ector
Shower Stall Backflow Assembl
Sinks Backflow Assembl Test
Bar Sink Lawn S rinkler
Water Closet Toilet Other
FEESCHEDULE
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
'ost w Building Permit #
The Minnesota Statutes $ 326B.14$
"SURCHARGE" has been changed for one pLUMBING PERMIT FEE $
year effective STATE SURCHARGE $ .50
July 1, 2010, until June 30, 2011. �
The minimum surcharge for a"fixed fee" permit TOTAL PERMIT FEE $
is �, beginning July 1, 2010
This Application Becomes Your Building Permit When Approved Paid Receipt No.
Date By
Baildin¢ Offfcial Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
l c�c��t�3 �