HomeMy WebLinkAboutPlumbing Permit #13-0417 �
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED .5 Z �
ADDRESS C� ��U w �� 1 CQ� _�����—" �
OWNER CONTR.
PMONE NO. PERMIT NO. (� '��� l
0 FOOTING 0 PLUMBING RI ❑ EX/GRADlFILLING
� FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMtNG ❑ WATER HOOKUP 0 FIREPLACE RI
0 INSUTATION O SEWER HOOKUP ❑ FfREPLACE FINAL
❑ FINAL ❑ PLUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION O MECH FINAL ,�[ � �y �c `��- �4��
COMMENTS:
�7 WORK SATISFACTORY, PROCEED
❑ CORRECT AC ION AND PROCEED
❑ CORRE RK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: �wnedContr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HF.,4LTH & SAFETY.�
WSNOTI
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04 p � p � Date Rec'd
,� CITY OF PRIOR LAKE PLUMBING PERMIT
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��g��� I. Blue File I�ERMIT NO .
2. Goid City I— �� .. a��
3. Yetiow Applicant �
lease or ' t and si at bottom �
ADDRESS - ZONIlVG �o�ce ��
`?j �P J�(� Vi�"' � l I��i� r.� T'i�I
LEGAL DESCRIPTION (office use onty)
LOT BLOCK ADDITION PID
OWNER )�i�,� �^��
(Name) , k'J IJ-� (Phone) �� 2- � 1° S° �� 7�
(Address) � �� � I a `' � �'C.O� � � � '
APPLICANT Ap�tian�e Connections Inc (Phone)
�� �: -.3 hestnut Blvd.
(Address) �f#aN �De� � �i��70
(Address) .; �,� ) �4�_480� (City) (Zip Code)
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(Contact Person) �d,l'Y11'� � ^ � (Phone)
APPLICANT SIGNATURE DATE �� 3
APPLICANT PLEASE COMPLETE BELOW
uanti T e of Fizture uanti T e of Fia�ture
Bath Tub with or without shower Rou h-ins
Dishwasher Water Heater
Floor Drain Water Softener
Lavato Bathroom Sink Stand Pi e Washin Machine
Laun Tra 1 or 2 com artment sink Sewa e E'ector
Shower Stall Backflow Assernbl
Sinks Backflow Assembl Test
Bar Sink Lawn S rinkler
Water Closet Toilet Other
FEE SCHEDULE
Industrial, Commerciat & 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 st $ Building Permit #
"SURCHARGE has been extended
until June 30, 2013,
PLUMBING PERMIT FEE $
The minimum surcharge for a STATE SURCHARGE $ .50
"fixed fee" permit is $5.00 TOTAL PERMIT FEE $�-
This Application Becomes Your Building Permit When Approved Paid �-� � Receipt o a v�
00
Date �--1, / � By
Buiidina Official Date ���Y
24 6onr notice for �U inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Mfanesota 55372
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