HomeMy WebLinkAboutPlumbing PErmit 11-0089 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED (�
ADDRESS 5 �3� �YO� q�.�
OWNER CONTR.
PHONE NO. PERMIT NO. �I -- (�Q� �
O FOOTING ❑ PLUMBING RI ❑ EXIGRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP 0 FIREPLACE RI
❑ INSULATION 0 SEWER HOOKUP O FIREPLACE FINAL
0 FINAL ❑ PLUMBING FINAL ❑�GASL NE AIR TST
❑ SITE INSPECTION O MECH FINAL �1 �
COMMENTS:
� WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORR C ORK, CALL FOR REINSPECTION BEFORE COVERING
Inspect OwnedContr:
CAL -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY!
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, �� PRIp Date Rec'd
� �9 CITY OF PRIOR LAKE PLUMBING PERMIT �_ G'j ,//
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P
I �'NESO�
1. Blue Fde pERMIT NO .
2 Gold C�ty �/. O O g
3. Yellow Apphcant
lease or ' t and si at bottom �
ADDRESS ZONING (ot�ce use)
5 3 � Gnoss ar�� � �� � ��
LEGAL DESCR�TION (office use only)
LOT BLOCK ADDITION PID
o�R �5� ���y��1
(Name) � _���ULIV � �� � I� (Phone)
(Address) �.(�l�j � � � 2
(NameC� � (Phone) � J� �-'(� J�'3`'1"�
(Address) �� �� " � �
(Address) ity) (Zip Code)
(Contact Person) (Phone) ��� �J� I��-t` �
APPLICANT SIGNATURE DATE Z
APPLICANT PLEASE COMPLETE BELOW
uanti 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 5tand 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
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 Statutes § 326B.148
"SURCHARGE" has been changed for one pLUMBING PERMIT FEE $ r��
year effective STATE SURCHARGE $ . 0(Y$
July l, 2010, until June 30, 2011.
The minimum surcharge for a"fixed fee" permit TOTAL PERMIT FEE $ •�j
is �, beginning July 1, 2010
This Application Becomes Your Building Permit When Approved Paid C � Re ' t No. /„� /� �
.J !1 �/ l�
Date � � � � I By
Buildine Ofticial Date '
24 hour notice for all inspections (952) 447-9850, faz (952) 447-4245
4646 Dakota Street 5.E., Prior Lake, Minnesota 55372 � I.��� L�
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