HomeMy WebLinkAboutPlumbing Permit #12-0376 V
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CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED ����!� _..—.--
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ADDRESS
OWNER CONTR.
PHONE NO. PERMIT NO. / � �_..��
D FOOTING ❑ PLUMBING Rt ❑ EXlGRAD/FILLING
❑ MECH RI ❑ COMPLAINT
❑ FOUNDATION O FIREPLACE RI
❑ FRAMING 0 WATER HOOKIlP
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINA�
p PLUMBING FINAL ❑ GAS NE AIR TST
❑ FINAL �
❑ SITE iNSPECTION ❑ MECH FINAI.
COMMENTS:
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� "[3 WORK SATISFAC?ORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector.
Owner/Contr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS lN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY!
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� pRI Date Rec'd
° �� CITY OF PRIOR LAKE PLUMBING PERMIT
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1. Blue File pERMIT NO .�' ' Z /�
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3. Yellow Applican[ L/ ` L �
Please or 'nt and si n at bottom �
ADDRESS ZONING (office use)
3��0 �` �� I � C��
LEGAL DESCRIPTION (otTice use only)
LOT BLOCK ADDITION PID
OWNER
(Name) (Phone)
(Address)
APPLICANT —/
(Name) � (Phone) �� �� / r ���
(Address)
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(A ss) (City) (Zip Code)
(Contact Person) � ' (Phone) ���'� �� ��7
APPLICANT SIGNATURE DATE
APPLICANT PLEASE PLETE BELOW
Quanti T e of Fixture Quanti 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
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% of job cost with a$49.50 minimum Residential, New One & Two-Family $149.50
Residential, Additions & Alterations $49.50
The Minnesota Statutes § 326B.148 ost $ Building Permit #
" SURCHARGE " has been changed for one pLUMBING PERMIT FEE $ •'J
year effective
July 1, 2010, until June 30, 2011. STATE SURCHARGE $ '�
The minimum surcharge tor a"fixed fee" permit TOTAL PERMIT FEE $
is $5, beginning July 1, 2010
_ __ __ _ _
This Application Becomes Your Building Permit When Approved Paid���,.� Re �p No. � �
• Date B
BuildinE Official Date �• t � � •
24 hour notice for all iuspections (952) 447-9850, fax (952) 447-4245
4646 Dakota 5treet S.E., Prior Lake, Minnesota 55372