HomeMy WebLinkAboutBuilding Permit 11-0167 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED yi22( 1
ADDRESS i 6277 2 . k 40Q, °Q.C6/
OWNER CONTR. I
PHONE NO. PERMIT NO. I ` — I (
❑ 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: iVt, 0 ( --__
A
WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRE• f K, CALL FOR REINSPECTION BEFORE COVERING
Inspector. �. Owner /Contr:
CALL 0 . 7 -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
0e, 1RIO Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
•
�'N ..ESO '
I. Blue File PERMIT NO
2. Gold City . p ' I I„
� `
3. Yellow Applicant �LJ
(Please type or print and sign at bottom)
ADDRESS ZONING (office us )
R07 box ry 96 - N
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID 25_ _ 3vt+ . b?.4- .0
OWNER
ame T1 YYl R \iCi n (Phone) 9'52- 2Z 5JO0
(Address) 1 6 o'c' v-06e, N y 5 5 J7 a
APPLICANT
(Name) Champion Plumbing (Phone)
# 61770 -PM
(Address) 651-365-1340
(AftV(s)Dodd Rd. (City) (Zip Code)
Eagan, MN 55123
(Contact Person) (Phone)
APPLICANT SIGNATURE V ~ 7 �iG' DATE c. 2
� - 14 - I
1
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough -ins
Dishwasher r 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 � /���yy
year effective PLUMBING PERMIT FEE $ '7"1. 5a
July 1, 2010, until June 30, 2011. STATE SURCHARGE $ 5 . L? OW'
The minimum surcharge fora "fixed fee" permit a TOTAL PERMIT FEE $ 5 r So
is 55, beginning July 1, 2010
This Application Becomes Your Building Permit When Approved Paid,/ S � Rece' No. 6z/57
Date - • f I By
Building Official Date •
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 /0/4646 Dakota Street S.E., Prior Lake, Minnesota 55372