HomeMy WebLinkAboutPlumbing Permit 11-0137 ATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED �1 1 1 �� 3G7
ADDRESS � 3 70 ��_ST��.c�O� �/�,
OWNER CONTR.
PHONE NO. PERMIT NO. ��'� � J 7 �
O FOOTING ❑ PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
FINAL �LUMBING FINAL O GASLINE AIR TST
❑ ITE INSPECTION ❑ MECH FINAL ❑
COMMENTS: � � � p{.�,cIA�(�}—r�-� S�'S
/ /�WORK SATISFACTORY, PROCEED
'� `ORRECT ACTION AND PROCEED
❑ CORRECT WOR , CALL FOR REINSPECTION BEFORE COVERING
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Inspector: OwnerlContr:
CALL 447-98 NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY.�
WSNOTI
p4 P �jo,� Date Rec'd
ti � CITY OF PRIOR LAKE PLUMBING PERMIT 3 �` �, �,
� �
� ��'
NNES�
I. Blue File pERMIT NO .
. 2. Gold City
3. Yellow Applicant
(Please e or rint and si at bottom)
� ADDRESS ZONING (ott'ice use)
��� - � - c� �V ����6� �iliVl ��/�v 1 ���
LEGAL DESCRII'TION (ofif'ice use only)
LOT BLOCK ADDITION PID Z, j Q� 3.
OWNER
(Name) (Phone)
(Address)
APPLICANT
(Name)��-: c,\c sa,r-, P K C`� (Phone) �l t.e 3- ��3 `{ � S
(Address) t�'{ 1 L �j ��-. � 4►.� 1JE � �� ;..�.a 5� �-(`�
(Address) (City) (Zip Code)
(Contact Person) (Phone) 'Zt� � "7 83 y Sy5
APPLICANT SIGNATURE DATE
APPLICANT PLEASE COMPLETE BELOW
Quanti T e of Fixture Quanti T e of Fixture
Bath Tub with or without shower Rou h-ins
� Dishwasher Water Heater
Floor Drain Water Softener
Lavatory (Bathroom Sink) � Stand Pipe (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
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% ofjob cost with a$49.50 minimum Residential, New One & Two-Family $149.50
Residential, Additions & Alterations $49.50
� Estimated Cost $ � • �� Building Permit #
PLUMBING PERMIT FEE $ l.{q ,sTj
STATE SURCHARGE $ � .d0
TOTAL PERMIT FEE $ S�, Sp
(Office Use Only)
This A p}icatien co � s Your Building Permi �W n Approved Paid �� � Rec ' t No. � Z ���
. ; ;., � t �
� Date �_ -' � � B
Buildine Official date � '
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
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