HomeMy WebLinkAboutPlumbing Permit #09-0267 � v
� DATE TIME
CITY OF PRIOR LAKE
lNSPECTION NOTICE SCHEDULED � ' �/'° /` �
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OWNER CONTR.
PHONE NO. PERMIT NO. �Q ��,� l� �
0 F0071NG � PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMtNG ❑ WA7ER HOOKUP 0 FtREPLACE RI
❑ INSULATION O SEWER HOOKUP ❑ FIREPLACE PINAL
O FINAL ❑ PLUMBING FINAL ❑ G LINE AIR TST
❑ SITE INSPECTION O MECH FINAL �
COMMENTS: ,.-��
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0 iNORK SATISFACTORY, PROCEED
❑ CORRECT AC710N AND PROCEED
❑ CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERlNG
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Inspector: ) OwneNContr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 NOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY.�
lNSNOTI
� pR V Date Rec'd
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'� ���i` �� CITY OF PRIOR LAKE PLUMBING PERMIT . S Z /� a°J
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�. B�„� File PERMIT NO. � �
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3. Yellow Applicant
ease or and s at bottom ZONING (otrce usc)
ADDRESS
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LEGAL DESCRIPTION (oPfice use only)
LOT BLOCK ADDITION PID
O�VNER �� I (Phone) �� -�7�f' /L r�
(Name)
(Address) < (✓ � 1 O !ct
.a►rp�c.�rrr / � l.� '-�� f �?� 8'
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(Address) . + a �� ��t � /(� d2 �
(Address) (City) (Zip Code)
(Contact Person) ���•"� �✓i4No'rC C— (Phone) f/,� 30� � 7l C�
APPLICANT SIGNATURE - DATE
APPLICANT PLEASE COMPLETE BELOW
Quanti T of Figture uanti T of Figture
Bath Tub with or without shower Rou -ins
Dishwasher Water Heater ;
Floor Drain Water Softener
Lavato Bathroom Sink Stand Pi e Washin Machine
Laund Tra 1 or 2 com artment sink Sew e E'ector
Shower Stall Backflow Assembl
Sinks Backflow Assembl Test
Bar Sink Lawn S rinkler
Water Closet Toilet Other
FEE SCHEDULE
Industrial, Commercial 8c Multi-family 1% of job cost with a 549.50 minimum Residentiai, New One & Two-Family 5149.50
Residendal, Additions & Alterations 549.50
Estimated Cost $ Building Permit #
PLUMBING PERMIT FEE $ ¢�� �
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $ .5?J, �
(OtBce use onry)
This Application Becomes Your Building Permit When Approved Paid� � R pt o��¢�
D�� 2 �, o
Buildius Otficirl Date
24 hour ootice for all inspections (952) 447-9850, fas (952) 447 45
4646 Dakota Street S.E., Prior Lake, Minoesota 55372
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