HomeMy WebLinkAboutPlumbing Permit 11-0054 DATE TIUE
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED � �`� (
ADDRESS 5 � 88 �T�A � ��� c
OWNER CONTR.
PHONE NO. PERMIT NO. ' dUs�
❑ FOOTING O PLUMBING RI ❑ EXIGRADIFILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
0 FRAMING ❑ WATER HOOKUP ❑ FIREPIACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPIACE FINAL
❑ F{NAL ❑ PLUMBING FINAL � GASLf IE AIR 7ST
❑ SITE INSPECTION ❑ MECH FINAL ❑ I.f�
COMMENTS:
'�WORK SATISFACTORY, PROCEED
✓ -
❑ CORRECT ACT10N AND PROCEED
❑ CORREC RK, CALL FOR REINSPECTION BEFORE COVERING
I nspector: OwnedContr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY!
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• � � pRlp Date Rec'd
� � �� CITY OF PRIOR LAKE PLUMBING PERMIT
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I NNESO�
1 Blue F�le pERMIT NO . �/ O/1�
2 Gold C�ty �
3 Yellow Apphcant %
ease or rint and si at bottom
ADDRE 1� � `� ZONIlYG �a�ce,��
5 � � r
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
�aWNER � �� (Phone) � ��/ . lU r w
(Address) ��i � � � L--IJ"� �r� c� � � ��
APPLICANT Champion Plumbing
(Name) # 61770-RM (Phone)
651-365-1340
(Address) 3670 Dodd Rd.
(Address agan, 55123 (City) (Zip Code)
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(Contact Person) (Phone)
APPLICANT SIGNATURE DATE � ��` —1 `
APPLICANT PLEASE COMPLETE BELOW
uanti T e of Fixture QuanN T e of Fizture
Bath Tub with or without shower Rou h-ins
Dishwasher ater Heater
Floor Drain Water oftener
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 & Two-Family $149.50
Residentiat, Additions & Alterations $49.50
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'ost $ , Building Permit #
The Minnesota Statutes § 326B.148
"SURCHARGE" has been changed for one pLUMBING PERMIT FEE $
year effective STATE SURCHARGE $ .50
July 1, 2Q20, until June 30, 2411. Q
The minimum surcharge for a"tixed fee" permit TOTAL PERMIT FEE $ ,
is �5, beginning July 1, 2010
This Application Becomes Your Building Permit When Approved Paid �, `� Rece' No. /���
�/� (0
Date / � / / By
Buildine Ofticial Date ( (
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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