HomeMy WebLinkAboutPlumbing Permit 11-0133 DATE TIME
CITY OF PRIOR LAKE � �
INSPECTION NOTICE SCHEDULED
ADDRESS V
OWNER CO R.
PHONE NO. PERMIT NO. ( I —( 37
❑ FOOTING O PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP O FIREPLACE FINAL
❑ FINAL � PLUMBING FINAL ❑ GAS INE R T T
� SITE INSPECTION ❑ MECH FINAL �'
COMMENTS:
�WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORR RK, CALL FOR REINSPECTION BEFORE COVERING
Inspect . OwneNContr:
C 447 850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY.�
lNSNOTI
� p �1 Date Rec'd
° �� CITY OF PRIOR LAKE PLUMBING PERMIT 3, 3� ��
� �M
�� ;P
'. B'°e F"` pERMIT NO.
2. Gold Ciry�
3. Yellow Applicant � � �
Please e or rint and si n at bottom)
ADDRESS ZONING (ot� use)
� �' • � . . �,� —
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER � �� (��,
(Name) � � � (Phone) � J ��1� �� �' �
(Address) � � m� �j (,7 � r�'��
APPLICANT
(Name) ��,ar�,�ic�n �lumbint� (Phone)
� *�� 770
(Address) ���; - 36� - 1340
(�f��odd Rd, (City) (Zip Code)
�ag���, (v�N 55123
(Contact Person) ��I 5 (Phone)
APPLICANT SIGNATURE DATE � I"" I I
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 (l 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
Thc Minncsota Statutcs ,��' 326B.148 �ost $ Building Permit #
"SURCI InRGI;" has been changed 1'or one
ycar cfCcctivc PLUMBING PERMIT FEE $ � Ct 517
.luh� 1, 2010, until ,lunc 3t), 2U1 I. STATE SURCHARGE $ S.- U�.50
The minimum surchargc for �"fixcd fcc" permit � TOTAL PERMIT FEE $
is tiS, beginning.luly 1. 201U �, � 5 �
This Application Becomes Your Building Permit When Approved Paid r� � c ipt No �I O
J � l.�
Date � � �
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 � U� �
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