HomeMy WebLinkAboutPlumbing Permit 11-0303 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED OAP(
ADDRESS J 40S `
OWNER CONTR.
PHONE NO. PERMIT NO. I (
❑ FOOTING ❑ PLUMBING RI ❑ EX/GRAD /FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
❑ FINAL ❑ PLUMBING FINAL ❑ GASLIINEA R TST
❑ SITE INSPECTION ❑ MECH FINAL 2( („)4 + Swe !-
COMMENTS:
• ■
IITPEKTMR_
y WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRE• f) '' CALL FOR REINSPECTION BEFORE COVERING
Inspector: / Owner /Contra
CALL 447 -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
pRlp Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
x
tti
IvivESD
I. Blue File PERMIT NO . Yell City NO. p / . 03
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
1 AM 5 QY sE SS3
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION • PID
OWNER (�
(Name) GY. `I Ynfkc ( Phone ) 507 - I - 3S
(Address) "\ Noy ur v,1 O dl S SC
APPICANT
(Name) CULLIGAN WATER CONDITIONINQ (Phone)
6030 CULLIGAN WAY
(Address) MINNETONKA, MN tx534;
(Addre052) 933 -7200 (City) (Zip Code)
(Contact Person) (Phone)
APPLICANT SIGNATURE le i . V DATE " l 1
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough -ins
Dishwasher Water Heater
Floor Drain 1 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
`;ost $ a j O .0 () Building Permit #
The Minnesota Statutes § 326B.148
"SURCHARGE" has been changed for one PLUMBING PERMIT FEE $ 9 .
year effective
July 1, 2010, until June 30, 2011. STATE SURCHARGE $ S. 00
The minimum surcharge for a "fixed fee" permit TOTAL PERMIT FEE $ 54 5 O
is $5, beginning July 1, 2010
This Application Becomes Your Building Permit When Approved Paid 3-4. Rece • r o. / is/4e
Date B ( a
Building Official Date ¢ - / /
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 ,
4646 Dakota Street S.E., Prior Lake, Minnesota 55372