HomeMy WebLinkAboutPlumbing Permit #13-466 �
pATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED r-- � G�—/�
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OWNER CONTR.
PHONE NO. PERMIT NO. �. S' �( �� k- °
� FOOTING 0 PL.UMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMtNG ❑ WATER HOOKUP 0 FIREPLACE Rt
� INSULATION � SEWER HOOKUP ❑ FIREPLACE FINAL
O FINAL ❑ PLUMBING FtNAL O GASLINE AIR TST
❑ SITE INSPECTfON O MECH FlNAI. � C�,_�/
COMMENTS:
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�'�- WORK SATISFACTORY, PROCEED
❑ CORRECT AC710N AND PROCEED
❑ CORRECT WORK, CALL FOR REINSPECTlON BEFQRE COVERtNG
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Inspector. �r$� OwnedContr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS !N ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH � SAFETY.�
WSNOTI
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o � pRZ Date Rec'd
�, CITY OF PRIOR LAKE PLUMBING PERMIT
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� ,. B�� File PERMIT NO. 7 /
2. QoIA Cily �J „� � . 6
3. Yello�v Applicani T
Please or ' t and ei n at bottom
�D�SS SS3`� M a ve S� r�. ',1 �� Zo�G �o�� �,
LEGAL DESCItIPTION (oHE'ice use only)
LOT BLOCK ADDITION PID
OWNER ° n
(Name) � � � � � V�� �� (Phone)
(Address) � �N
�ame 1 � S a�. lV `(1� , � � � �t (Phone q� LI z � 4 �1y L �
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(Address) ��� �' �� v�"' �- c`l' KJl1'�D-e--e. s�� G I
(Addxess} (City} �— (Zip Code)
(Contact Person) ��� �V� `lw� 1 OI �lM ►� . �I lKX � (Phone} I� � � J� � � � �
APPLICANT SIGNATUR� DATE
APPLICANT PLEASE COMPLETE BELOW
uanti T e of Fixture uanti e of Fixture
Bath Tub with or without shower Rou h-ins
Dishwasher Water Heater 1
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, Commeroial & Multi-family 1% of job cosi with a$49.50 minunum Residential, New One & Two-Family $149.50
Residentia(, Additions & Alterations $49.50
"fha Minnesota Statutes ¢ 32Gf3.14R
' "' �st $ `�• � Building Permit #
"SUi2CHr1RGE" has been changed for one pLUMBING PERMIT FEE $ � Q�»
ycar et�'ective
Ju1,v 1. 2010 untii June 30 zof i. STATE SURCHARGE $ 5'. t+� .'.�8.
'1'he mirtimum s��rchnrge for � fee" permit TOTAL PERMIT FEE $ S�. C�
ls �j, beglnning July 1, 301U
This Applicatfon Becomes Your Bnilding Permit When Approved Paid �i /�� Receipt No� �D �[�
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Date� L � � By
BuildLne Otflcial Date
24 hour notice for all inapections (952) 447-9$50, f�x (952) 447-4245
4646 Daicota Street S.E., Prior Lake, Minnetota 55372
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