HomeMy WebLinkAboutPlumbing Permit 11-0261 D E TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDUL D (0 11 `l2
ADDRESS 4 40 l.� (6,N • Q"•i --
OWNER CONTR.
PHONE NO. PERMIT NO. (, L - SS - 1 –
❑ FOOTING ❑ PLUMBING RI ❑ EX/GRAD /FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
❑ FINAL ❑ PLUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION \ ❑ MECH FINAL ❑
COMMENTS: .
1 gikeVaD
Gc.49s63-- F-a L &
WORK SATISFACTORY, PROCEED
CORRECT ACTION AND PROCEED
❑ CORRECT ' , • LL FOR REINSPECTION BEFORE COVERING
41 A
I nspector: c Own- ontr:
CALL 447 -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
1NSNOTI
pRip Date Rec'd
• CITY OF PRIOR LAKE PLUMBING PERMIT #/le/f/
z-.) e„7
IvivESo. I. Blue File
2. Gold city PERMIT NO. // z62
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
81 ,re 61 y yliot ea
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
(Naame) r.111t\t l /1 A 1\ 0 (Phone) L I L I 1
(Address) &SAC ` c O r L ck ( ' Y t 5 5 5 7 a
APPLICANT
(Name) Champion Plumbin (Phone)
# 61 / /U - PM
(Address) 651 - 365 - 1340
? ���e a'd Rd. (City) (Zip Code)
ll an,IN 55123
(Contact Person) 6 (Phone)
APPLICANT SIGNATURE A ,.. ZZ _ — - DATE t ( "1 - 1 I
6'
PPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough -ins
Dishwasher Water Heater
Floor Drain Water Softener
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (1 or 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
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
The Minnesota Statutes § 326B.148 'ost $ Building Permit #
"SURCHARGE" has been changed for one PLUMBING PERMIT FEE $ 1 49 , 60
year effective
July 1, 2010, until June 30, 2011. STATE SURCHARGE $ S • 6050
The minimum surcharge for a "fixed fee" permit TOTAL PERMIT FEE $ °)c-j- j 0
is $5, beginning July 1, 2010
This Application Becomes Your Building Permit When Approved Paid tiI_ Receipt No.( 5 �
Date ` jl . j ,9 ✓/ I By
Buildine Official Date `t' / G
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 1 a3$
4646 Dakota Street S.E., Prior Lake, Minnesota 55372