HomeMy WebLinkAboutPlumbing Prmit 11-0849 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED sc , 7 1 q
ADDRESS ) 01 X Z C,.at t
OWNER CONTR.
PHONE NO. PERMIT NO. // _Aye/
❑ FOOTING ❑ PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
❑ FINAL ❑ PLUMBING FINAL �❑( GA UNE AIR TST
❑ SITE INSPECTION ❑ MECH FINAL . "1" _ t-tr
COMMENTS:
n
CfrAp_ A_ 1 i (...„
2( WORK SATISFACTORY, PROCEED
CORRECT ACTION AND PROCEED
❑ CORRECT CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner /Contr:
CA 447- 50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSIOT1
PR Date Rec'd
L'',
CITY OF PRIOR LAKE PLUMBING PERMIT 8 30_1 r
1�
.-
4INNES(�., 1. Blue ile j
2. Gold F c,tY PERMIT NO./
3 Yellow Applicant
JR1ease -or nt and sign at bottom)
ADDRESS ZONING (office e)
l6 / 21 L4 s,',< /4 s.E.
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
O.at
02 - o 134.4 lkite W Sir( (Phone) W? - S 4-sr
(Address) 161 2.1._ C ., ht 5, t A.,,.c • S' .t.
(Name CAN V 'tn 41 b t t *1- C_ hone) U" ° 375 Z
• dress e.0 00 /• 1 2 5 1 P d o L.1-,- 014. , SC ! 7 Z
(Address) (City) (Zip Code) — ontact Perso
j &-t— (Phone) 6 / / 70 ~ 6 el 2 —
s4 ' • LICANT SIG : 1l Ill! ' DAT g r 3 a /l/
A PPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without 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
` - ^ost $ Building Permit #
The Minnesota Statutes § 326B.148
"SURCHARGE" has been extended PLUMBING PERMIT FEE $
until June 30, 2013, STATE SURCHARGE $ .50
The minimum surcharge for a TOTAL PERMIT FEE $ , a _D
"fixed fee" permit is $5.00
This Application Becomes Your Building Permit When Approved Paid Building No. 6 .40 7 . ,i
Bulldina Official Date Daff ° / B .
24 hour notice for all inspections (952) 447 -9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372