HomeMy WebLinkAboutPlumbing Permit 11-0149 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED � �
ADDRESS 3� � 3 � D�L ��P
OWNER CONTR.
PHONE NO. PERMIT NO. �
O FOOTING O PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION O MECH RI ❑ COMPLAINT
� FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
❑ FINAL ❑ PLUMBING FINAL •� GAS INE AIR T T
❑ SITE INSPECTION ❑ MECH FINAL Jp W ♦
/�
COMMENTS:
OSQ, .
� WORK SATISFACTORY, PROCEED
CORRECT A ION AND PROCEED
❑ CORRE RK, CALL FOR REINSPECTION BEFORE COVERING
Inspecto Owner/Contr:
CA L 7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY!
lNSNOTI
� P Rip Date Rec'd
,°�`' '�` � CITY OF PRIOR LAKE PLUMBING PERMIT 3 �� � I
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;. R'°` F"` pERMIT NO. � � � b ��(_
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3. Ycllow Applicant ��
Please e or rint and si n at bottom)
ADDRESS ZONING (ott��e use)
���� I �dd � - S�'V
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER � \ . 1^,' � l L /�,`
(Name) �Lk.1.LI I _)� 1� I �Z �G�W(� 11S �"3� vl (Phone) , s..l � �7 `7 V � 7_��
(Address) (. {�J ;(i� � �j , cri
APPLICANT
(Name) (Phone)
# 61770
(Address) � �T��r�� n
(Add�� Dodd Rd. (City) (Zip Code)
��gan, MRI 5512�
(Contact Person) r1S (Phone)
APPLICANT SIGNATURE DATE � `�— /
APPLICANT PLEASE COMPLETE BELOW
Quanti T e of Fixture Quantit T e of Fixture
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
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
The Minnesota Statutes ,��' 326[3.148 ost $ Building Permit #
"SURCHARGG" has been chan�ed for one
year effective PLUMBING PERMIT FEE $�
July I. 2010, until Junc 30, 201 l. STf�TE SURCHARC�iE � 5 l, t� ---�-�—�'
Thc minimum surch�rgc for a" rr�d r���� permi� � TOTAL PERMIT FEE � �� - ,`j J
is !'>, beginnin� July I. 2010
This Application Becomes Your Building Permit When Approved Paid � �1 Rece' t No. ��� �
.JIJ
Date By
Buildina 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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