HomeMy WebLinkAboutPlumbing Permit 11-0202 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED Lf /SI
ADDRESS ' ! 5 l 3
OWNER CONTR.
PHONE NO. PERMIT NO. / 1 262
❑ 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 4 ) p r t:4_,-
WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT K, CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner /Contr:
CALL 447 -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
rRi'o Date Rec'd
0 ~ + CITY OF PRIOR I,AK,E PLUMBING PERM
44„,Esoo I. slue Pile PERMIT NO. ' 1 _2 c L
2. Gold City
3. Yellmv Applicvm
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
/ C yr%a e L
�1
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
O
(Name) ( 1 e4/1 1'C- t °S it (Phone)
(Address)
/
_ 1 2) I/ (/ 7 cl 4,e_ L ry 'L.,(
II
APPLICANT+ p 1
(Name) ( . lfit/VU'l �T'I/ P 4f (Phone) 75d "L/ 3 �l
(Address) l q Z 11 0 1 U J(/ /YY �V I t � LL/ 7743
(Address) (City) (Zip Code)
(Contact Person) _ ' d AIII (Phone) q5, - Le . - 7'
APPLICANT SIGNATURE „re, . _ L _��s91- j _) DATE 31
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 Water Softener
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (1 or 2 compartrnent sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
L 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 Be Alterations $49.50
The Minnesota Statutes § 32613.148
— ist $ Building Permit # t , - 2..- 4-) Z
"SURCHARGE" has been changed for one �J
year effective PLUMBING PERMIT FEE $
July 1, 2010, until June 30.201 20H. STATE SURCHARGE $ t. cJ .49
m
The minimu surcharge fora "fixed fee" permit TOTAL PERMIT FEE $ `'t a S
is 5.5, beginning July 1, 2010
Th
...dine Official pplication Bec mes Your Building Permit When Approved
ne� Paid i _ r V Receipt No. / Z i
"1 v v 1
0 — U 1 —A \ Date o�� < ( By 6C\
24
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372