HomeMy WebLinkAboutPlumbing Permit 11-0271 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 4/d //
ADDRESS I1D 2i U,! Q J .-S L
OWNER CONTR.
PHONE NO. PERMIT NO. I I — ari l
❑ FOOTING ❑ PLUMBING RI ❑ EX/GRAD /FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
INAL ❑ PLUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION ❑ MECH FINAL ❑
COMMENTS: 1 -0a,,Q - (f(
ley
WORK SATISFACTORY, PROCEED
CORRECT ACTION AND PROCEED
❑ CORRE K, CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner /Contr:
CALL - 850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
4 PRI0 Date Rec'd
° , CITY OF PRIOR LAKE PLUMBING PERMIT 4 ZU 1'
NvivESOi,P
1. Glad File PERMIT NO. 1 / a Z 7
2. Gold City
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS
W � ^ �, �� _ , ZONING (office use)
(.` c& Cue SE
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
O r \ O. & ( P hone) - / 7 -90
7
(Address) scu of t pn0 .6,182. , o ss3
APPLICANT Champion Plumbing
(Name) # 61770 -PM (Phone)
651 - 365 -1340
(Address) 3670 Dodd Rd.
�/ (Address) Eagan, MN 55123 (City) (Zip Code)
(Contact Person) ice, r 1 S 0 - (Phone)
APPLICANT SIGNATURE DATE L i — l CO — / 1
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Ro h -ins
Dishwasher I 6ater Heat;
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 e, Bu Permit #
"SURCHARGE" has been changed for one
year effective PLUMBING PERMIT FEE $
July 1, 2010, until June 30, 2011. STATE SURCHARGE $ .50
The minimum surcharge fora "fixed fee" permit TOTAL PERMIT FEE $ ��,�
is $5, beginning July 1, 2010
This Application Becomes Your Building Permit When Approved Paid co Rece No. ( a2,6 ---6 2___
Date B
13uildine Official Date � ' �/
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
/OD-3? 0 CPC