HomeMy WebLinkAboutPlumbing Permit 11-0095 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 2 /
ADDRESS �r �.�'��Ce �(�N.�.Ati,�/ ��
OWNER CONTR.
PHONE NO. PERMIT NO. (�"' F�
❑ FOOTING ❑ PLUMBING RI ❑ EX/GRADIFILLING
❑ FOUNDATION O MECH Rt ❑ COMPLAINT
0 FI2AMING O WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION O SEWER HOOKUP ❑ FIREPLACE FINAL
❑ FINAL ❑ PLUMBING FINAL �ASL E AI ST
❑ SITE INSPECTION ❑ MECH FINAL
COMMENTS:
'�l6lORK SATISFACTORY, PROCEED
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❑ CORRECT ACTION AND PROCEED
❑ CORR O , CALL FOR REtNSPECTION BEFORE COVERING
Inspe r: OwneNContr:
C 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREINENTSARE FOR YOUR PERSONAL HEALTH & SAFETY!
uvsrvon
. 04 pRlp� Date Rec'd
,� � CITY OF PRIOR LAKE PLUMBING PERMIT 2, � I
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1 Blue F�le pERMIT NO . �
2. Gold C�ty
3 Yellow Appl�cant
lease or ' t and si at bottom
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LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
o�R ��- a��--s��
(Name) (Phone)
(Address �--��"� � � ('� Y l�ljv� 1\.J � � � p�
APPLICANT Champion Plumbing
(Name) � a� ��n_cna (Phone)
651-365-1340
(Address) �7(] I7nrlrl Rri
(Address) EagSn, MN 55123 (City) (Zip Code)
(Conta.ct Person) � ' (Phone)
APPLICANT SIGNATURE DATE d U ��,
APPLICANT PLEASE COMPLETE BELOW
Quanti T e of Fixture uanN T e of Fizture
Bath Tub with or without shower
Dishwasher Water Heate
Floor Drain a er o ener
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
�st $p��• Building Permit #
The Minnesota Statutes � 326B.148
"SURCHARGE" has been changed for one pLUMBING PERMIT FEE $
year effective
duly 1, 2010, until dune 30, 2011. STATE SURCHARGE $ .50
The minimum surcharge for a "fixed fee" permit TOTAL PERMIT FEE $_�SN , �
is �, beginning July 1, 2010
This Application Becomes Your Building Permit When Approved Paid� .� Rec t No. � ZO �
Buildine Official Date Dat� '�/ �/ B
24 hour notice for all inspections (952) 447-9850, faz (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
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