HomeMy WebLinkAboutPlumbing Permit 11-0075 t
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DATE TIME '
CITY OF PRIOR LAKE •
INSPECTION NOTICE SCHEDULED 2 �� ��
ADDRESS L�i�_ � �
OWNER CONTR. �
PHONE NO. PERMIT NO. j�� bO� �
❑ FOOTING ❑ PIUMBING RI O EXIGRADIFILLtNG
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
a FINAL ❑ PLUMBING F1NAL O GASLINE AIR TST
❑ SITE INSPECTION ❑ MECH FINAL ❑
COMMENTS: � �
�WORK SATISFACTORY, PROCEED
❑ CORRECT ACTIO D PROCEED
❑ CORRECT R, LL FOR REINSPECTION BEFORE COVERING
Inspector: OwnedContr.
CALL 44T-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODB REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY!
uvs�vorr
� pRlp Date Rec'd
� �� CITY OF PRIOR LAKE PLUMBING PERMIT Z, Z,( �
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I Blue File pERMIT NO .
2 Gold City � � ` (l O �
3. Yellow Apphcant V
lease or ' t and si at bottom
ADDRESS � ` `,,, �, ZONING �o�re,��
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LEGAL DESCRIPTION (ofleice use only)
LOT BLOCK ADDITION PID
OWrTER `T( `�f �� "L>��[11
(Name) (Phone)
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(Address) � � �
APPLICANT Champion Plumbing
(Name) #,� (Phone)
651
(Address) ��n n,,,�,� o.�
(Address) Eagan, MN 55123 (ci�y) (zip Coae)
(Contact Person) � ^ � _, (Phone)
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APPLICANT SIGNATURE DATE �
APPLICANT PLEASE COMPLETE BELOW
uanti T e of Fixture Quanti T e of Figture
Bath Tub with or without shower R
Dishwasher Water Heater
Floor Drain 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
FEE SCHEDULE
Industtial, Commercial & Multi-family 1% of job cost with a$49.50 minimum Residential, New One & Two-Family $149.50
Residential, Additions & Alterations $49.50
OO
ost $ ) Building Permit #
The Minnesota Statutes § 326B.148
"SURCHARGE" has been changed for one pLUMBING PERMIT FEE $
year effective STATE SURCHARGE $ .50
July 1, 2010, until June 30, 2011. `$ O
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 /� r?l Rece' t No. j_� �
J �V l9
Buildine Official Date Date1 �� I By ,
aN
24 hour norice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372 �
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