HomeMy WebLinkAboutPlumbing Permit 11-0444 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED C¢ /2.6 ///
ADDRESS MO ° I C I Lca,4a, 1A
OWNER CONTR.
PHONE NO. PERMIT NO. f( d ( ( 4 /
❑ FOOTING ❑ PLUMBING RI ❑ EX/GRAD /FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
❑ FINAL ❑ PLUMBING FINAL AG j$T
❑ SITE INSPECTION ❑ MECH FINAL T r
COMMENTS:
WORK SATISFACTORY, PROCEED
O CORRECT ACTION AND PROCEED
❑ CORRECT 'O" / ALL FOR REINSPECTION BEFORE COVERING
Inspector: /111P Owner /Contr:
CALL 447 -9; 0 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
04 PRI0 Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
4 kN E SO
1. Blue File
2 Gold City PERMIT NO. 1/
.
3. Yellow Applicant • +O
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
lyegg ,.a)Li /VC ? Zink
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER /
3, Th /C • (core_ s (Phone) ?S a -
(Address) /`7/ (0 / / Z CL .) (--/t/ /()�
APPLICANT fn�/ II �1 �y
( Name) C Sl iTWA.) J� (Phone) 6 /c: — 6 o - [1 ? o D
(Address) 30 3 e-AsOA) /hre_ ,C-/t(/ec L33O
(Address) (City) (Zip Code)
(Contact Person) €3 4 (Phone) COIrZ - c O 2 -5 —t ?
APPLICANT SIGNATURE DATE CO / / /a07/
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 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
Estimated Cost $ Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid Rec� No.
Date / . / / B
Building Official Date p •
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372