HomeMy WebLinkAboutPlumbing Permit 11-0067 DATE TIN1E
ClTY OF PRIOR tAKE
INSPECTION NOTICE SCHEDULED 2�2;5'�/�
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ADDRESS � � S � � �C���Q ��
OWNER CONTR.
PHONE NO. PERMIT NO. � I�'aQ (D�
❑ FOOTING O PLUMBING Rt ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI O COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPIACE FINAL
Q FINAL O PLUMBING FINAL O� GASL E AjF� �ST
❑ SITE INSPECTION D MECH FINAI '�'hr
COMMENTS:
,
�WORK SATISFACTORY, PROCEED
� CORRECT ACTION AND PROCEED
O CORREC RK, CALI FOR REINSPECTION BEFORE COVERING
Inspector: OwnerlContr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETYi
�vs�ron
, O � PRIp� Date Rec'd
� � CITY OF PRIOI2 LAKE PLUMBING PERMIT
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,. B��e Fi1e pERMIT NO. (,
2. Gold C�ry
3. Yellow Applicant �• 0 V
lease e or ' t and si at bottom)
ADDRESS ZONING (otHce use)
I � � �,bi� Tr� �(��.
LEGAL DE�CRIPTION (office use only)
LOT BLOCK ADDITION PID
(Na�meE .� M ��✓ (Phone) � S `Z'"`�'7 ��� � � ,T_
(Address) . �5 3�
APPLICANT
(Naxne) � (Phone)
# 61770-PM
(Address) �51 ���$�8
(Addre��70 DOdd Rd. (City) (Zip Code)
Eagan, MN 55123
(Contact Person) (Phone)
APPLICANT SIGNATURE DATE � 1
APPLICANT PLEASE COMPLETE BELOW
uanti T e of Fixture uanti T e of Fixture
Bath Tub with or without shower Rou h-ins
Dishwasher Water Heater
Floor Drain Water Softener
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 .
Industrial, Commercial & Multi-family 1% of job cost with a$49.50 minimum Residential, New One & TwQ-Family $149.50
Residential, Additions & Alterations $49.50
'ost $ Building Permit #
The Minnesota Statutes § 326B.148 •
"SURCEIARGE" has 6een changed for one pLUMBING PERMIT FEE $
year effective STATE SURCHARGE $ • 0 0:3�9'
July 1. 2010, until June 30, 2011.
The minimum surcharge for a"tixed fee" permit TOTAL PERMIT FEE $�, �
is ��, beginning July 1, 2010
This Application Becomes Your Building Permit When Approved Paid Receipt No.
Date By
Buildin¢ Offfcial Date
, 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372 � �(� � f 7t�
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