HomeMy WebLinkAboutPlumbing Permit 11-0124 DATE TIIAE
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 3 u
ADDRESS �J`�O) Cp��y �in�
OWNER CONTR. _
PHONE NO. PERMIT NO. ��'� 2 �
❑ FOOTING O PLUMBING Rt O EX/GRADIFILLING
❑ FOUNDATlON � MECH RI ❑ COMPLAINT
O FRAMING ❑ WATER HOOKUP O FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
❑ FINAL O PLUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION ❑ MECH FINAL ❑
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COMMENTS: ��(� �� � ,
c�s2 �
WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORR T ORK, CALL FOR REINSPECTION BEFORE COVERING
Inspecto : OwnedContr:
C T-9850 FOR THE NEXT INSPECT'!ON 24 HOURS 1N ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH d� SAFETY!
Wsroon
4 PRip Date Rec'd
F � 9 CITY OF PRIOR LAKE PLUMBING PERMIT
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1 Blue F�le pERMIT NO .
2 Gold C�ty I/ D/ Z�
3. Yellow Appl�cant
lease e or ' t and si n at bottom
ADDRESS ZONING (ott use)
fl ' � F_
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
(N R LZ'�1 nQ.f� c� r C�c-" ��w� 1 Y)�� — (Phone) �, Z 2�� —S�""`T
(Address) a
APPLICANT
(Name) CheumplQrl Plumblrtg (Phone)
# 61770-PM �
(Address) 651-365-1340
� , MN 55123 (City) (Zip Code)
(Contact Person) (Phone)
APPLICANT SIGNATURE DATE �� ZZ I(
APPLICANT PLEASE COMPLETE BELOW
uanti T e of Fixture 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 ashin 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 ¢ 3268.148
"SURCHARGE" has been changed for one PLUMBING PERMIT FEE $ ��
year effective STATE SURCHARGE $ $A
duly 1, 2010, until dune 30, 20u. TOTAL PERMIT FEE $ �.�tl
The minimum surcharge for a"fixed fee" permit
is �5, b July 1, 2010
This Application Becomes Your Building Permit When Approved Paid ��� � Rec ipt No. �� b
Date Z` Z � � b � B
Buildine Ofticial Date
24 hour notice for all inspections (952) 447-9850, fag (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372 � b � � c�
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