HomeMy WebLinkAboutPlumbing Permit #12-0458 V
� � � DATE TIME
CITY OF PRtOR LAKE
tNSPECTION NOTICE SCHEDULED � ���`�'/.�
ADDRESS �/ �J�Q� � ��1�.[��,�1,,� l > L� � W
OWNER CONTR.
PNONE NO. PERMIT NO. l '��j �'J
O FOOTING O PLUMBING RI ❑ E7UGRAD/FILLING
❑ FOUNDATION ❑ MECH RI O COMPLAINT
O FRAMING ❑ WA7ER HOOKUP ❑ FIREPCACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
O FINAL O PLUMBING FINAL �GASL . AIR TST
❑ SITE tNSPECTION ❑ MECH FINAI �
COMMENTS: �� �
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C`� WaRK SATlSFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector. OwnerlContr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE F01P YDUR PERSONAL HEALTH & SAFETY!
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o � PKip� Date Rec'd
,� -�� CITY OF PRIOR LAKE PLUMBING PERMIT
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A �NNES�� P
�. a��� Fi1e pERMIT NO.
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ADDRESS ZONIl�TG �o�a ���
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LEGAL DESCRIPTION (ofl6ce use only)
LOT BLOCK ADD£TION pID
OWNER
(Name) (Phone)
(Address)
APPLICANT
�� GEN Z- RYAN {Phone) 9 5 2- 7 6 7-18 4 7
(Address) 2200 IGHWAY 13 W, BURNSVILLE, MN 55337
(Address) (City) (Zip Code}
(ContactPerson) LISA HERNANDEZ 952-767-1847
(.Phone}
APPLICANT SIGNATURE DATE 2
APPLICANT PLEASE COM ETE BELOW
Quanti T e of Fixture uantit T e of Fixture
Bath Tub with or without shower Rou h-ins
Dishwasher Water Heater
Ploor Drain Water SoRener
Lavato Bathroom Sink Stand Pi e ashin Machine
Laund 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
FEE SCHEDULE
Industrial, Commercial & Multi-family 1°/a of job cosL with a$49.50 minimurn Residendal, New One &'Itvo-Family $(49.SQ
Residentiat, Additions & Alterations �49.50
"Fhe Minnesota 5tatutes � 326I3.]dR � �st $ - 1 � • � $uilding Permit #
"SURCI•IARG1:" has been changed for o�te
ycar et7'ective PLUMBING PERMIT FEE $
.r„iy� �, ztr9a antil Jnne 30 zt�t �. STATE SURCHARGB $ .50
The mireimum sorchnr�e for x "fixed Pec" permir TOTAL PERMIT FEE $
is �i, bcginning Juty 1, 20]0
Th[s Application Becomes Your Bnilding Permit When Approved Pa.id S -, / S —� R ipt No.� f „ 7 Ap
`T! !
Date S. Z� �2 y
Boildtn8 Offtcial Date .
24 Rour noNce for all inspec4iona (952) 447-985U, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Mlnnesota 553'12