HomeMy WebLinkAboutPlumbing permit 11-0313 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 640_
ADDRESS 11 \ I (— •
OWNER CONTR.
PHONE NO. PERMIT NO. ( I -3 ( �j
❑ FOOTING ❑ PLUMBING RI ❑ EXXJGGRAD /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: kZi.) (��
e (05e (42t/(__ (I
WORK SATISFACTORY, PROCEED
CORRECT ACTION AND PROCEED
❑ CORRECT W. ' , CALL FOR REINSPECTION BEFORE COVERING
Inspector: iii
Owner /Contr:
CAL 44 985' FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE ' ' ' IREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
icv RIp Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
ZIE
x
V tri
.,... S�� I. Blue File
2. cold City PERMIT NO. / /. 3 /3
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS _ ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
(Name) R A It 0 1 \ LkJR.S (Phone , 5 Li
(Address) J& II , ,A 1 L n
(Name) N C AN , 11 P rai) \ n L(Phone\ 1 4 0 (-O
(Name) � � x�tC ) 1�� - �
(Address) ` 1� 1 (� m . W \ �� `'l, C \
� I (A ess) (City) (Zip Code)
(Contact Person � � \ i A . (Phone)
Arj) i_:-
APPLICANT SIGNATURE DATE l
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
The Minnesota Statutes § 326B.148 st $ Building Permit #
"SURCHARGE" has been changed for one �� ��
year effective PLUMBING PERMIT FEE $
July 1, 2010, until June 30, 2011. STATE SURCHARGE $ S. 0 a
The minimum surcharge fora "fixed fee" permit c
is S5, beginning July 1, 2010 TOTAL PERMIT FEE $ �J
1
This Application Becomes Your Building Permit When Approved Paid 5 6 - 3 Rec ' No. / (d z 7
Date , /(9 //
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