HomeMy WebLinkAboutPlumbing Permit #13-0432 V
DATE TIME
CtTY OF PRSOR LAKE
INSPECTION NOTICE SCHEDULED ,��'�"�.- —1,�
ADDRESS II"� I �l � ��„T�""�y�`� �f jq�S;�
OWNER CONTR.
PHONE NO. PERMIT NO. !-�' `'� �.Y�
D FOOTING � PLUMBING RI ❑ EXlGRAD/FILLING
❑ FOUNDATION ❑ MECH RI 0 COMPIAINT
O FRAMING ❑ WATER HOOKUP ❑ FIREPIACE RI
❑ INSULATION � SEWER NOOKUP ❑ FIREPLACE FINAL
❑ FINAL O PLUMBING FiNAL O GASLINE AIR TST
❑ SITE INSPECTION ❑ MECH FINAI. ,� Z �". �
COMMENTS:
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`Ci WORK SATISFACTORY, PROCEED
d CORRECT ACTION ANq PROCEED
❑ CORRECT WORK, CA�L FOR REINSPEGTION BEFORE COVERING
3.
Inspector: � OwnerlContr.
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CAL� 447-9850 FOR THE NEXT 1NSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY!
1NSNOt7
V
� pRlo Date Rec'd
��'" �-.�, � CITY OF PRIOR LAKE PLUMBING PERMIT
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z. aoia ca PERMIT NO. ��__ a��
3. Yellow Appli�anl
Please or rint and si n at bottom
ADDRESS ZONII�TG �ot�« ��
I �' �l �l 1 �f � �` �ss r �v� � I �'l SS"3 Z-.
LEGAL DESCRIPTION (ofi6ce use anly)
LOT BLOCK ADDITIf�N �'ID
OWNERT ,, l
(Name) V � � 1.��-�Te. (Phone)
{Aaaress) I�-}-q q 1���e+-s �'�-�s s�I r or � 37Z-
(Name)�P� V��� ` Y� � (Phone)
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(Address) 1�7�F8� G��d1 a..,d ��j., Lc�,,,��1� Mr�! ssd�`�
(Addxess) (City) (Zip Code)
(Contact Person) � / l� l, en � I "l c � � � (Phone) � S Z — Ct 53-- � �Y 3
APPLICANT SIGNATURE DATE �/` ,�
PLIC.ANT PLEASE COMPLETE BELOW
Quanti T e of Fixture uant� e of Fixture
Bath T'ub with or without shower Rou h-ins
Dishwasher Water Heater
Floor Drain Water Softener
Lavato Bat,�room Sink Stand Pi e ashin Machine
Laund Tra 1 or 2 com artment sinic Sewa e E'ector
Shower Stall Bacl�low Assennbl
Sinks Backflow Assembt Test
Bar Sink Lawn S rinkler
Water Closet Toilet Other
FEESCHEDULE
Industrial, Commerciai & Multi-family 1% of job cosi wirh a$49.50 minimum Residendal, New One & TtvaFamily $149.50
Resideniial, Additions & Alterations $49.50
T'he Minnesota Statutes § 32fiB.]48 ��st $ Building Permit #
"SURC.HARGE" has been ct►anged for one
year effective PLUMBING PERMIT FEE $ 5�
.1uty i, 2010 untii ,7une 3fl 20I i. STATE SURCHARGE $ ---�—�. .50
The minimom snrcharge for a "tFxed fee" permit TOTAL PERMIT FEE $ �'/`_ Jn
is �, beginning Juty l. 2010
This Application Becomes Your Bailding Permit When Approved Paid �� /�� Receipt No. ` pQ Q 7
�" lp 7
Date �/� �/� By �
Bailding Otfldal Date `��
24 hour noHce for all inspections (952) 447-985Q, fax (952) 447-4Z45
4646 Dakota Street S.E., Prior Lake, Milnnesota 55372