HomeMy WebLinkAboutPlumbing Permit 11-0085 DATE T{IAE
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED l
ADDRESS � L( t�, g� �`/��j� l„�
OWNER CONTR.
PHONE NO. PERMIT NO. I I— C� ��S
O FOOTiNG ❑ PLUM8ING RI ❑ EJUGRADIFiLLiNG
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP 0 FIREPLACE Rf
❑ INSULATlON O SEWER HOOKUP ❑ FIREPLACE F{NAL
❑ FINAL ❑ PLUMBING FINAL O GASLIN AIR TST
❑ SITE INSPECTION � MECH FINAL J� ��
COMMENTS:
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�WORK SATISFACTORY, PROCEED
❑ CORRECT N AND PROCEED
❑ CORREC W K CALL FOR REINSPECTION BEFORE COVERING
Inspector: OwnedContr.
CALL 44 -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH dc SAFETY!
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� 4 p RIp Date Rec'd
,° �� CITY OF PRIOR LAKE PLUMBING PERMIT
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1 Blue Fde pERMIT NO . �
2. Gold City 0
3 Yellow Appl�cant
lease or ' t and si at bottom
ADDRESS ZONING (og'ice use)
3 � r . l� �
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
o�R � h � 9`52-�5—Z..�
(Name) N ofmc,n ��-f Ct� � c J v � � (Phone)
(Address) � � � �.� Q, � � � ' ��� � �
(Name) �T ����f�ior� Riumbing (Phone)
(Address) 651-365-1340
�`°' ��t, MN 55123 (City) (Zip Code)
(Contact Person) (Phone)
APPLICANT SIGNATURE DATE ��� 1
APPLICANT PLEASE COMPLETE BELOW
uanH T e of Fixture Quanti T e of Fizture
Bath Tub with or without shower Rou h-ins
Dishwasher Water Heater
Floor Drain Water Softener
Lavato Bathroom Sink Stand Pi e Washin 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
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 $ Building Permit #
The Minnesota StatuYes � 326B.i48 jj�
"SURCHARGE" has been changed for one pLUMBING PERMIT FEE $ 7`7'S�
year effective STATE SURCHARGE $ �, DC7 50
July 1, 2010, until June 30, �0! �. TOTAL PERMIT FEE $ ,`�j�_ Sl7
The minimum surcharge for a"fixed fee" permit
is �, beginning July 1, 2010
This Application Becomes Your Building Permit When Approved Paid �� �—y� Recei o. ��
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Date �� Z � / / By
Buildin¢ Official Date
24 6our notice for all inspections (952) 447-9850, faz (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Miunesota 55372 r D(��'�
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