HomeMy WebLinkAboutPlumbing Permit 10-1179 TE TIME
CITY OF PRIOR LAKE ,r�
INSPECTION NOTICE SCHEDULED 3 !( G-� r"'
ADDRESS L j � �1 `
OWNER CONTR.
PHONE NO. PERMIT NO. `� � �
❑ FOOTtNG 0 PLUMBING RI ❑ EXfGRADJFILLING
❑ FOUNDATION O MECH RI O COMPLAINT
❑ FRAMING ❑ WATER HOOKUP O FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
❑ FINAL �LUMBING FINAL O GASLINE AIR TST
❑ SITE INSPECTION ^ ❑ MECH FI AL ❑
COMMENTS: ����iqfia7t�-
�
RK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT , L FOR REINSPEC710N BEFORE COVERING
Inspector: Contr:
CALL 447-9850 FO HE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE RBQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY!
ws�vort
� pltip Date Rec'd
F �� CITY OF PRIOR LAKE PLUMBING PERMIT
� x Stacey Forst
v �' 15239 Fairway Heights Court
�I�'NESD�P Prior Lake, MN 55372
Blue Fde pERMIT NO . /' // �
9522261564 coia aty
Yellow App6cant V �
lease e or rint and si at bottom
�D�$S I � �� ' � � � � � �� � ZONING (ot�ei�e use)
� �c� I -N",
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
(NaWmiER � V t, (Phone) ��/ !��-C.Y� ���1
(Address) ' ' � 6 J l� ( �
APPLICANT
(Name) (Phone)
PLUMBtNG CO.
(Address)
(City) (Zip Code)
S ARFIELD AVE. SO.
(Contact Person) (Phone)
APPLICANT SIGNATURE � DATE ( � �
APPLICANT PLEASE COMPLETE BELOW
Quanti T e of Figture Quanti 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
Laund 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
The Minnesota Statutes § 326B.148 ost $ O' oO Building Permit #
"SURCHARGE° has been changed for one G,O
year effective PLUMBING PERMIT FEE $_�'�
July 1, 2010, until June 30, 201 I. STATE SIJRCHARGE $ .500
The minimum surcharge for a"fixed fee" permit TOTAL PERMIT FEE $
is �5, beginning July 1, 2010
This Application Becomes Your Building Permit When Approved Paid ��• S ,� ipt No� r� y -
l
Date �
Buildin¢ Official Date ('jj ,> 0,� d
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372