HomeMy WebLinkAboutPlumbing Permit 11-0111 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 3 l
ADDRESS I���,, / 1!) l���M-(JCJ��, �� �
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OWNER CONTR.
PHONE NO. PERMIT NO. ��'— L� 1
❑ FOOTING O PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION O MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
❑ FINAL O PLUMBING FINAL O IAIE A TST
❑ SITE INSPECTION ❑ MECH FINAL �Q
COMMENTS:
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�WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORREC RK, CALL FOR REINSPECTION BEFORE COVERING
Inspect : OwnedContr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY!
�vsnor,
� � pRip Date Rec'd
F �� CITY OF PRIOR LAKE PLUMBING PERMIT
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l. Blue File pERMIT NO .' f . O t I 1
2. Gold C�ty
3 Yellow AppLcant � � j
lease or ' t and si at bottom
ADDRESS ZONING (ot��,��
5d '�L, b Gt, Tr�c,i
LEGAL DESCRIPTION (oflFce use only)
LOT BLOCK ADDITION PID
OWNER I �,(�� � � � y �
(Name) �JC>I 3 �X,�.rl � � l� �O (�cSDi'� (Phone) 50 � ��(
(Address � � 5 � � a
APPLICAN � f " �p5 --I3�b
(Name) (Phone)
(Address) Q- ' " � ' `+ ��' �
Address) (C (Zip Code)
(Contact Person) r� S (Phone) �/�_ �� � ' � t„ ��
APPLICANT SIGNATURE DATE �`�u I
APPLICANT PLEASE COMPLETE BELOW
QuanN T e of Figture uanti 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
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
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
$ Building Permit #
The Minnesota SYatutes § 326B.148
"SURCHARGE" has been changed for one PLUMBING PERMIT FEE $ t
year effective �TATE SURCHARGE $ . OI�.S@'
.Tuly 1, 2010, until.Tune 30, zot 1. TOTAL PERMIT FEE $
The minimum surcharge for a"Fized fee" permit •
is �, beginning July 1, 2010
This Application Becomes Your Building Permit When Approved Paid �✓� Receipt No. �� O,/
U
Date 2 � �� !' By
Bullding O�cial Date .
24 hour notice for all inspections (952) 447-9850, faz (952) 447-4245 /D � D ��
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
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