HomeMy WebLinkAboutPlumbing Permit #13-983 . � .3 '\ 7 "l /�' k`f„�` S�
- �E TIME
CITYOF PRIOR LAKE ` �� " � �� f' � �
INSPECTION NOTICE SCHEDULED
ADDRESS �'�,,;�" 8 ¢ � � �-
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OWNER CONTR. -/
PHONE NO. PERMIT NO. '
0 FOOTING 0 PI.UMBING RI ❑ EX/GRADIFILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION O SEWER HOOKUP C] FtREPLACE FINAL
O FINAL O PLUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION O MECH FINAL ❑
COMMENTS:
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WORK SATISFACTORY, PROCEED
❑ CORRECT AC710N AND PROCEED
❑ CORRECT WORK, CA FOR REINSPECTION BEFORE COVERING
Inspector: u .:�������{GrDwner/Contr.
CALL 44�-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETYl
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�! � CIT'I' O�' P�2i0� LA� PLIJI��ING PE�II'I' � C� �(3
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3. Yellow Applicant
(Please e or rint and siPn at bottom)
ADDRESS ZONIlVCr (ot�ice use)
5���`� �cc.�'�� . 1�11/�/ US.�
LEGAL DESCR�TION (office use only)
LOT� BLOCK � ADDITION -T����l3 GL�/¢7`.2���py! ��� PID - �J -���D
OWNER , (� U (
(Name) o Cl �� �-�' 1U �(k C'1 �1 Y ) (�(/V') (Phone) `� °�„� �.Jd � � c...�l
(Address) � � � (� � , � J 3 l �'
APPLICAN � 2, �p
(Name) (Phone) � � ✓� �`� �
(Address) 0 �.--� �.+(1 _ Q� �� 2�
, (Address) _ itY) (Zip Code)
(Contact Person) ��� (Phone)
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APPLICANT SIGNATURE DATE `� 3� � �
APPLICANT I'LEr�SE COIVIPLETE �ELOW
uanti T e of Fixture uanti T e of Fizture
Bath Tub with or without shower Rou h-ins
Dishwasher Water Heater �
� Floor Dra' t Water Softener
" ' � �a�ato Batl3room-Sink _ ;''?� ^ : Stand Pi e ashin M '
Laun Tra 1 or 2 com ariment 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
'ost $ Building Permit #
The Minnesota Statutes ,��' 326B.148 ,
"SURCEIARGE" has been changed for one pj,jJj�,�jNG PERMIT FEE $ �q'��
year effective
,�uly 7, 20i3, until Jan� 3�, 20�1. STATE SURCHARGE $ ,-0.7 :�'0
The minimum surchargc for a'' fce" permit TOTAL PERNIIT FEE $ -
is ��, bcginnind July 1, ZOIQ
This Application Becomes Your Suilding Permit When Approved Paid �-� / s� Receipt No. / Q Q'
`r' 10 / �
Date �� Q /, � By ' �
Buildinz Official Date �SC
24 hour notice for all inspecrions (952) 447-9550, faY (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
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