HomeMy WebLinkAboutPlumbing Permit #13-1137 �
D TE . TIME
CITY OF PRIOR LAKE J
INSPECTION NOTICE SCHEDULED / ?�-
/
ADDRESS � �
OVYNER CONTR.
PNONE NO. PERMIT NO. � �j —� �� �j �
. �
❑ FOOTING ❑ PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP 0 FIREPLACE Rt
0 INSULATION ❑ SEYVER HOOKUP ❑ FIREPLACE FINAL
O FINAL ❑ PLUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION O MECH FINA� ❑
COMMENTS: � ` � _ �' � � ,� , � ��
,
�_.._.�
�MORK SATISFACTORY, PROCEED
O CORRECT AC?ION AND PROCEED
❑ CORRECT WOR FOR REINSPECTION BEFORE COVERING
Inspector: . `� p�ynedContr:
� - 50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH.f SAFETY.�
fNSNOTI
V
Date Rec'd
o� p � O � CITY OF PRIOR LAKE PLUMBING PERMIT �b , j�� ��
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F
v
,�� �. B�Ue Fite PERMIT N4• r?
2. Gold City �__ , .
3. Yellow Applicant
lease or ' t and s' at bottom ZONING (office use)
ADDRESS � `
LEGAL DESCRIPTION (office use only) p � � � a � O �
LOT � BLOCK � ADDITION � � � 4 "0 � "' �
i �.t�� �
pWNER (Phone) �
(Name)
(Address)
APPLICANT tIOt1S IC1C. (Phone)
(Name) 12850 Chestnut Bivd.
(Address) , (City) (Zip Code)
(A re 2_445-4803
(Phone)
(Conta.ct Person) �
` ` DATE
APPLTCANT SIGNATURE
APPLICANT PLEASE COMPLETE BELOW ,r e of Fixture
T e of Fixture uanti
uanti Rou h-ins
Bath Tub with or without shower Water Heater
Dishwasher Water Softener
Floor Drain stand Pi e ashin Machine
Lavato Bathroom Sink Sewa e E'ector
Laun Tra 1 or 2 com artment sink gackflow Assembl
Shower Stall Backflow Assembl Test
Sinks Lawn S rinkler
Baz Sink Other
Water Closet Toilet
FEE SCHEDULE
Residential, New One & Two-Family $149.50
Industrial, Comtnercial & Multi-family 1% of job cost with a$49.50 minimum Residential, Additions & Atterations $49.50
The Minnesota Statutes § 326B.148 St $ Building Pe it #
"SURCHARGE" has been extended �n —
The minimum surcharge for a pL�g�G PERMIT FEE $ �—�`�
°fixed fee" permit is $5a00 STATE SURCHARGE $
TOTAL PERMIT FEE $ —
.
(OfEice Use ooly) � � jtgceipt No. �' �
a S
This Application Becom Your Building Permit When Approved y
�� . 1 � � l � Date � � �' By
Baildine Ofticiai Date
��� 4646 Dakota Str p S.E Prior Lake, Minnesot 9 553�'�245
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