HomeMy WebLinkAboutPlumbing Permit 12-0093 DAT TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED /2__
ADDRESS '303 C Q r-
OWNER CONTR.
PHONE NO. PERMIT NO. ) z b I
❑ FOOTING ❑ PLUMBING RI ❑ EX/GRAD/ /FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
❑ FINAL ❑ PLUMBING FINAL p A AI
❑ SITE INSPECTION ❑ MECH FINAL �T T � COMMENTS:
WORK SATISFACTORY, PROCEED
❑ CORRECT TION AND PROCEED
❑ CORRE W K, CALL FOR REINSPECTION BEFORE COVERING
Inspector: _ Owner /Contr:
CALL 447- 850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS' ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
ciii , PR„,o . Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT Z , /Z
'
I. Blue Cit PERMIT NO./2 9
2. Yel App
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
230 5 5A & cre,s - i -- Wefir, V\/ •
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
(Nam E n 5. C`6or J (Phone) 954 2 I I 2)--
(Address) C 52 1► ,6 I'' a C L 101N 5 53"7
(NameC �. /��u r Qr 1 P im b t n (Phone) (661 �S ' S
D
(Address) O �-�'l d e KA A
ty) 1 V � `N 55/23
ddress) (Zip Code)
(Contact Person) 4 4 Iji (Phone) C'✓ti' r 11<-J
. ' j
APPLICANT SIGNATURE DATE \'_ 3t. --2---
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough -ins
Dishwasher k 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
The Minnesota Statutes § 326B.148 st $ Building Permit #
"SURCHARGE" has been extended "I
�(�
until June 30, 2013, PLUMBING PERMIT FEE $ " [ .53
The minimum surcharge for a STATE SURCHARGE $ .50
"fixed fee" permit is $5.00 TOTAL PERMIT FEE $ ./1
This Application Becomes Your Building Permit When Approved Paid T/ 5 -6 Rec ' t No.ee SZ r
Date . , ?. /Z B
Buildine Official Date t
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 Ue 4646 Dakota Street S.E., Prior Lake, Minnesota 55372