HomeMy WebLinkAboutPlumbing Permit #12-1105 �
v�" DATE TIME
CtTY OF PRIOR LAKE SCHEDULED �
INSPECTION NOTtCE
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OWNER CONTR.
PHONE NO. PERMIT NO. I� `�� ��
O FOOTING D PLUMBING RI ❑ EXIGRAD/FILLING
❑ MECH RI O COMPLAINT
p FOUNDATION p FIREPLACE RI
O FRAMING O WATER HOOKUP
❑ INSULATION O SEWER HOOKUP ❑ FIREPLACE FINAL
❑ FINAL tJ PLUMBING FINAL ❑ GASLIN�AIR TST
❑ SITE INSPECTION O MECH FINA� � f � ����
COMMENTS:
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❑ WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector. " � OwnerlContr.
CALL 44T-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HF.ALTH & SAFETY!
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� ,� pRr�� Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
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3. Yellow A��licant
lease ar' t and s' at bottom
ADDRESS ZONING �ot�«,�>
� 20 ��crG� I�r � �-�; ��-=
LEGAL DESCRIl'TION (office use onty)
LOT BLOCK ADDITION PID
(Na.�me) Cl, �/ J " l,U � S (Phone) �� 2 "�'� "��� 1
(Address) � � �� �
(NameCANT � � ` V , � (�' ) ��� � �J�D� 1 ��
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(Address) �� ��� ��
(Address) ( ) (Zip Code}
(Contact Person) (Phone)
APPLICANT SIGNATURE DATE
APPLICANT PLEASE COMPLETE BELOW
uanti T e of Fi�cture uanti T e of Fizture
Bath Tub with or without shower Rou h-ins
Dishwasher Water Heater
Floor Drain Water Softener
Lavato Bathroorn Sink Stand Pi e ashin Machine
Laun 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 i% of job cost with a$49.50 minimum Residentiat, New One & Two-Farnily $149.50
Residential, Additions & Aiterations $49.50
The Minnesota Statutes § 326B.148 $ Building Permit #
"SURCHARGE" has been extended
until ]une 30, 2013, PLUMBING PERMIT FEE $ �
The minimum surcharge for a STATE SURCHARGE $ S 0 .�8
"fixed fee" permit is $5.00 TOTAL PERMIT FEE $_� , t
This Application Becomes Your Building Permit When Approved Paid ���"� Receipt No. ` 7 � O �
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Date (y % y By
suua�$ ot�c�t nsc� �
24 hour noNce for all jnspections (952) 447-9851l, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
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