HomeMy WebLinkAboutPlumbing Permit 11-0264 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 1 -1 / 41/1"
ADDRESS 2(z N) I Y' S L vl ‘
OWNER CONTR.
PHONE NO. PERMIT NO. I 1 — 267
❑ FOOTING ❑ PLUMBING RI ❑ EX/GRAD /FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
❑ FINAL ❑ PLUMBING FINAL ❑ GAS INE AI TST
❑ SITE INSPECTION ❑ MECH FINAL )6 r�
COMMENTS:
c /0 5- e lAt - 1( :\ (Le
WORK SATISFACTORY, PROCEED
CORRECT ACTION AND PROCEED
❑ CORREC� y K, CALL FOR REINSPECTION BEFORE COVERING
Inspector: Air Owner /Contr:
CALL 447 -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
!NSNOTI
Date Rec'd
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1,...4 CITY OF PRIOR LAKE PLUMBING PERMIT
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I. Glad File PERMIT NO. / / z6,4_... a Gold City
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
C W i 1 01:5 LOA M
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDl'1'lON PID
OWNER —h Ob f (.weed v.. -) (Phone)
(Address) aw a w ' 10 . Lc,e_ N LC)
(Name)) l tif1 `l'1 -GSt7 V
T G. 1' l U��MS 1 S t`1 r � (Phone) c / YD- l 9r L/ y�i'!
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(Address) 1 9 U o - ,,d lam/,-_ .3,.WIAD -.-e_ SS31
�,� (Address) [� (City) 1 (Zip Code)
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(Contact Person) 1 ' L 1 Panfv ,--Q..e."(y- (Phone) S t ' 1 9 Li i - /L—/
APPLICANT SIGNATURE DATE
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough -ins
Dishwasher 1 Water Heater
Floor Drain Water Softener
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (1 or 2 com. artment sink Sewa ' e 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 Est $ e yUv Building Permit #
"SURCHARGE" has been changed for one
year effective PLUMBING PERMIT FEE $ l i g.CV
July 1, 2010, until June 30, 2011. STATE SURCHARGE $ S , W .36
The minimum surcharge for a "fixed fee" permit TOTAL PERMIT FEE $
is 5, beginning July 1, 2010 '
This Application Becomes Your Building Permit When Approved Paid S 'Vs Re e' t No. G 43
Date Gp
Building Official Date if, i( _
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372