HomeMy WebLinkAboutPlumbing Permit #12-1481 C/�
v /� DATE TIME
CITY OF PRIOR LAKE gCHEDULED ����� —
{NSPECTION NOTICE
ADDRESS � ` �� ��� �
OWNER CONTR.
PHONE NO.
PERMIT NO. C �+ � � � � �
0 P�UMBING RI O EXIGRAD/FILLING
O FOOTING p �y{ECH RI ❑ COMPI.AINT
❑ FOUNDATION O FIREPLACE RI
O FRAMtNG ❑ WATER H�OKUP
❑ gEWER HOOKUP CI FIREPLACE FtNAL
❑ INSUlJ�T10N 0 p�UMBING FINAL ❑ GASLIN�A� 7ST
❑ FINAL p MECH FINAL "� �''�--�'�'
p SITE INSPECTION 1 � { �. Z �
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COMMENTS:
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p WORK SATISFAC70RY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERiNG
Inspector: � ,_ �+nerlContr:
CALL 447-98�0 FOR THE NEXT IN5PECTION 24 NOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY!
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Date Rec'd
4 r RI �
° �'� CITY OF PRIOR LAKE PLUMBING PERMIT
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� 1. Blue File PERMIT NO . �
2. Gold City �� ��
3. Yellow Applicant
lease or ' t and si at bottom
ADDRESS ZONING (ofleice use)
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LEGAL DESCRIPTION (ofll'ice use only)
LOT BLOCK ADDITION P�
OWNER
(Name) � (Phone)
(Address) 1 � ► � �C.J
APPLICANT ��{ (;��ip Inc
(Phone)
(Name)
(Address) ShakOpee, MN 55:379 zz Code
(Address) �-�5-�0 (City) � P )
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(Contact Person) � (Phone)
APPLICANT SIGNATURE
* ( DATE / �
APPLICANT PLEASE COMPLETE BELOW
Quanti T e of Fixture uanti T e of Fizture
Bath Tub with or without shower Rou h-ins
Dishwasher Water Heater
Floor Drain Water Softener
Lavato Bathroom 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
FEESCHEDULE
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
"SURCHARGE" has been extended pLUMBING PERMIT FEE $ � -�
until june 30, 2013, ' STATE SURCHARGE $ �
The minimum surcharge for a TOTAL PERMIT FEE $
"fixed fee" permit is $5.00 ,
This Application Becomes Your Building Permit When Approved Paid� (� Receipt No. / l
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Date 1 , /� BY
Buildin¢ Official Date L �
24 hour notice for all inspections (952) 447-9850, fax (952) 44'1-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
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