HomeMy WebLinkAboutPlumbing Permit #12-1442 TE TIME
CITY OF PRIOR LAKE �� ` ��,
INSPECTION NOTICE SCHEDULED � � /3 /'_.�C/
ADDRESS � `� �,� � 1�,7 �`�. � ` �
" OWNER CONTR.
I PHONE NO. ' PERMIT NO. ��� I�� ��
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I D FOOTiNG � PLUMBING RI O EX/GRAD/FILLIN(i
O FOUNDATION � MECH RI O COMPl.A1NT
O FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
� INSULATION O SEWER IqOKUP O FIREPlJ10E FINAL
O FINAL O PLUMBING FlNAL ❑ GASUNE AIR T8T
O StTE INSPECTION O MECH F1NAL O
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', COMMENTS: l..c.1 �.Z.,,I� �j,�""il.(�—
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�1MORK SATISFACTORY, PROCEED
' ❑ CORRECT ACTION AND PROCEED
O CORRECT , LL FOR REINSPECTION BEFORE COVERINO
' InspeUor. _.._, ---_ _,.. __ �v�eoe[CCoM�:
C LL 447-98b0 FOR THE NEXT SPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOU/t PERSONAL HE�lLTN d� SAFETYJ
Wsrwr,
O � pRlp� Date Rec'd
� 9 CITY OF PRIOR LAKE PLUMBING PERMIT
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l. Blue File PERMIT NO . �Z ,, f���
2. Gold Ciry �
3. Yellow Applicant
ease or ' t and si at bottom
ADDRESS ZONING �ot��,��
I'S y 83 s1n �� n-� �R SE
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
�aWNER� 1 C,� CX • V �l � Y"T"t'�JC�� (Phone) Q�J 2—�c' �P �Z.q�
(Address) l �
APPLIC.�TT� , � �.,�
(Name) ��' A l� 1 Q�'. � �,1(Z_��Q 1��� �. � (Phone) q �'�Z=y'-�[�� � �v �{�
(Address) I�LIL�S I�Lt'�a1C� �T • n�L nY � �� 1 ak � �� c55 312
(A ess) (City) (Zip Code)
(Contact Person) �. L � C� ��(d, �'I. I'� (Phone) q � Z - y �� — ��4' �
APPLICANT SIGNATURE DATE � Z / r/� Z
APPLICANT PLEA5E COMPLETE BELOW
Quanti T e of Fixture uanti T e of Fizture
Bath Tub with or without shower Rou h-ins
Dishwasher Water Heater
Floor Drain / Water Softener
Lavato Bathroom Sink Stand Pi e Washin Machine
Laun Tra 1 or 2 com artment sink Sewa e E'ector
Shower Stall Backflow Assembl
Sinks Backflow Assembl Test
Bar Sink Lawn S rinkler
Water Closet Toilet Other
FEESCHEDULE
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
D !7
Estimated Cost $ D� • Building Permit #
The Minnesota Statutes § 326B.148
"SURCHARGE" has been changed for one PLUMBING PERMIT FEE $
year effective STATE SURCHARGE $ .50
July 1, 2010, until dune 30, 2011. TOTAL PERMIT FEE $ SC7
The minimum surcharge for a"fixed fee" permit
is 5�5, beginning July 1, 2010
This Application Becomes Your l3uilding Permit When Approved Paid �� rn Receipt No. /�� q
J ci /
Buildina Official Date Date i., // I / / � By
/ !�/
24 hour notice for all inspections (952) 447-9850, faz (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372