HomeMy WebLinkAboutPlumbing Permit #12-0445 � ,� c.v
DATE TIME
CITY OF PRIOR LAKE
tNSPECTION NOTICE SCHEDULED �'{—'-� �l �
ADDRESS J �� T /j��f �.����a!�G[,l� (.s� ���
OWNER CONTR.
PHONE NO. PERMIT NO. � — ��L��jL�
D FOOTING ❑ PLUMBING RI ❑ EXIGRADIFILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
O FRAMING ❑ WATER HOOKUP ❑ FIREPU4CE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
❑ FlNAL ❑ PLUMBING FINAL O GAS NE AIR TST
❑ SITE INSPECTION L7 MECH FINAI y� �
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_COMMENTS: �'�""� ��:
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❑ WORK SATISFACT�RY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK, CALL FpR REINSPECTION BEFORE COVERtNG
Inspector: f OwnedContr.
CALI 447-9850 FOR THE NEXT INSPECTION 24 HOURS 1N ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY.�
/NSNOTI
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O ,� p Rip� Date Rec'd
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CITY OF PRIOR LAKE PLUMBING PERNIIT
U
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`. B,� r�� ( pT+ RMIT NO. I7 .�
z. oda cnY �
3. Yellmv Applicml
euae ar and at bottom
.'wnRESS zoxmrG co�� �,
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LEGAL DESCRIPTION {office vae only)
L�T BLOCK ADDITION PID
OWNER
(Name) (Phone)
{Address} '
APPLIC I'
(Name) I I� � (Phone) �,�,� � � � -.� � `t�
{Address) � 1r�Y� 'Y' 1
{Ad (City} (Zip Code}
(Contsct Person) {Phone) � � Z.' � �-�- � - � 53 �
APPLI�ANT SIGNATUR� DATE �'�' ZOI Z
APPLICANT PLEASE G4MPLETE BELOW
aantl of Ffxture uanfil e oFFf�cture
Bath Tub with or without shower Rou h-ins
Dishwasher Water Heater
FIoar Drain Water Sattener
� Lavato Bathroom Sink Stand Pi ashin Machine
Laun Tra 1 or 2 com artment sink Sewa e E'ectar
Shower Stali Backflow Assembl
Sinks Backflaw Assembl Test
Bar Sink Lawn S rinkler
Water Closet oilet Other
FEE SCHEDULE
Mnduatriat, Commercial & Multi-family !% of job cost with a$44.50 minimum R�esidential, New One &'I�vaFamily $149.50
Residential, Additions & Alterations $44.50 .
The Minnesota Stat�tes § 32GB.148
' ' '" ist $ `t'd • � � Building Permit # �
"SU�tCHARG�" has been changed for one pL�BING PERMIT FEE $ �'7 ' S�
year effective
•Juzy �, 2010 untif June 30 ZOI i. STATE SURCHAR.GE $ • O —.�0
The minlmum surcbarge for a "tixeil Pu'� pn•ro�t TOTAL PERNIIT FEE $
is �,i, beginni�g Juty 1, 20y0
Th�s Appl�cstlon Becom� Yonr Building Permit When Approved Paid � r S � Recei o. ����}'
I
8�:��g � �an �� �� ( � � I 2 �y -
24 6our notice for all iaspectlen: (9S2) 44'1-4850, fax (952) 447-4245
4646 Dakota Street SE., Pr3or Lake, Minne�ata 55372