HomeMy WebLinkAboutPlumbing Permit 11-0072 DATE TIAAE
C1TY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED �l
ADDRESS � ` t tQ �1� �% ,�j,.N/�(�l.A �� _
OWNER CONTR.
PHONE NO. PERMIT NO. ��"' DD� pZ„
❑ FOOTING O PLUMBING RI ❑ EXIGRADlFfLLiNG
❑ FOUNOATION ❑ MECH RI O COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
O INSULATION O SEWER HOOKUP O FIREPLACE FINAL
❑ FINAL ❑ PLUMBING FINAL Cy GASLI E AIR TST
❑ SiTE iNSPECTION ❑ MECH FINAL j��
COMMENTS: So�t�-
� WORK SATISFACTORY, PROCEED ,
❑ CORRECT AC N AND PROCEED
❑ CORRECT ORK, A L FOR REINSPECTION BEFORE COVERING
I nspector: Owner/Contr:
CALL 9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
�vor,
� p Rip Date Rec'd
� �� CITY OF PRIOR LAKE PLUMBING PERMIT Z �, ��
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1 Blue File pERMIT NO ./ O/1
2. Gold City V �
3 Yellow Appl�cant r
lease or ' t and si at bottom
ADDRESS ZONING (ot�ce use)
y b9 C�q��,M�,,� � Ss3 � g
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER j�
(Name) I�O'�0 � �.S 0✓� (Phone) �.5 a'� y �'� 3 � �
(Address) � �j �{s �OG�rn��� C-
APPLICANT
�� CULLIGAI�I WATEq r; (Phone)
6030 CULLIGAI�I WAY
(Address) MI NNFTnNE4����-.�s3��
(Ad�s��� 933-7200 (City) (Zip Code)
4—
(Contact Person) (Phone)
APPLICANT SIGNATURE DATE � � — I
APPLICANT PLEASE COMPLETE BELOW
Quanti T e of Figture uanti T e of Figture
Bath Tub with or without shower Rou h-ins
Dishwasher Water Heater
Floor Drain � Water Softener
Lavato Bathroom Sink Stand Pi e ashin Machine
Laund 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
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
The Minnesota Statutes § 3268.148 st $ �0� • �(� Building Pernut #
"SURCHARGE" has been changed for one
year effective PLUMBING PERMIT FEE $ 49 � �
.Tuly !, 2010, untii .Tune 30, 2011. STATE SURCHARGE $ :3A� S• �V
The minimum surcharge for a"fixed fee" permit TOTAL PERMIT FEE $ ,�y� $(�
is �,5, beginning July 1, 2010
This Application Becoroes Your Building Permit When Approved Paid Re e pt Nq! Y �,�c
,.�� f , s� c�
Date /
BuUdine Official Date � ( •
24 hour notice for all inspections (952) 447-9850, faz (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372