HomeMy WebLinkAboutPlumbing Permit #12-814 � TIME
pATE
C1TY OF PRIOR LAKE gCHEDULED ����� I
INSPECTION NOTICE
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ADDRESS L --
OWNER CONTR.
PHONE NO. PERMIT NO. ' �. �'S � �
❑ FOOTING 0 PI.UMBING RI � EX/GRADlFILLING
❑ FOUNDATION ❑ MECH RI 17 COMPLAINT
� FRAMtNG ❑ WATER HOOKUP ❑ FIREPLACE Rt
� INSULATION ❑ SEWER HOOKUP O FIREPLACE FINAL
❑ FtNAL ❑ PLUMBING FINAL ❑ GASLINE AIR TST
I� SfTE INSPECTION C7 MECH FINAI. � `
, :. /:��- a
COMMENTS:
,
f� WORK SATISFACTORY, PROCEED
❑ CORREC7 AC710N AND PROCEED
❑ CORRECT WORK, CALL FOR REINSPECTtON BEFQRE COVERtNG
Inspector: Owner/Contr.
CALL 447-9850 FOR THE NEXT tNSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
V
� � pRZ�� Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERNIIT
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��xESO`�
�. B �"` "��° PERMIT NO. � y-�'I��
2.Oold Cily
3. Yellow Applican�
ease or and si at bottom�
AnnxESS zoNnvG c�ce �,
� U$�j � �1�' �} s� ,IfJ �
LEGAL DESCRIPTION (office use only}
LOT BLOCK ADDTTION �'ID
{Na�meE l�� 1'n �b2 � � (Phone) ZW� ' Z.��' � ���
(Address) U �� � � c�� ° � ' �N '
APPLIC.AN v �,� � "�/-�
(Name) 1 1 1 �h i C�� • fPhone) ���J -t,.0 b� �
(Address) �� ✓ _l r ��4�' l^.UOr t11/ ��J����---1 1 1 � �/�� 1. �
(Addxess) {City) (Zip Code)
(Contact Person) ✓ �L• � �- (Phone) ��3 �Z���� V
APPLICANT SIGNATURE � "''" DATE � �t� � � �
APPLICANT PLEASE Ct3MPLETE BELOW
Quanti T e of �xture uan43 e of Ffxture
Bath Tub with or withou# shower Rou h-ins
Dishwasher Water Heater
Floor Drain Water Softener
Lavato athroom Sink Stand Pi e ashin Maclune
Laun Tra 1 or 2 com artrnent sink Sewa e E'ector
Shower Stall Backflow Assembl
Sinks Backflow Assembl Test
Bar Sink Lawn S rinkler
Water Closec ToiLet Other
FEE SCI-I�DULE �
Industrial, Commercial & Multi-family 1°/a of job cosi with a$49.50 minimum Residential, New One & Two-Family $149.5Q
Residential, Additions & Alterations $49.SU
The Mianesotu Statutes � 326B.14R
' `" �st $ , � Buiiding Permit #
" SURCHARGE " has been changed for one pLUMBTNG PERMIT FEE $
ycar effective
.July i, 2010, unti[ .fiune 3(1, 20! i STATE SURCHARGE $ .50
The miaimum s[�rcharge far a "�xed ree" permit TOTAL PERMIT FEE $
is,$�5, be�inning 3uty 1. 2U10
This� Application Becomes Your Bailding �ennit When Approved Paid ��� Receipt No. � �
r Date �/ / By
Baildios Offlcfal Date `f /�
24 6aur noHce for s11 inspections (952) 447-985Q, faz� (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372