HomeMy WebLinkAboutPlumbing Permit #14-151 CITY OF PRIOR LAKE DATE TIAAE
INSPECTION NOTICE SCHEDULED ���
ADDRESS U�p W�,�,Qj.a i �,,
OWNER CONTR.
PHONE NO. PERMIT NO. 1�--� �Lj �
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❑ FOOTING 0 PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
O FINAL ❑ PLUMBING FINAL ❑ GASLlNE AIR TST
❑ SITE INSPECTION ❑ MECH FINAL p
_COMMENTS: L„L, ���
.
� WORK SATISFACTORY, PROCEED
O CORREC CTION AND PROCEED
❑�C�ORRE T K, CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CALL 447- 50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL KEALTH & SAFETY.�
lNSNOTI
4 PRlp . Date Rec'd
� � CITY OF PRIOR LAKE PLUMBING PERMIT -. � L� � f�—
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. �. s �"` �"` PERMIT NO. l�� �J` / 1
2 Oold t5ry
3. YeElaw Applkain
leese ar t aad sl at bottom
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LECi�AI. DESCRIl'TI4N (ottice use on2y) ,
LOT BLOCK ADDITiON PID '
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(Name) (Phone)
(Address)
APPI.ICANT
(Name} _ �e R �'o R t� �t �u � e /OQ � , � c. �;�� (Phone) �,� /- yG ,� - / o"t o� 3
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cAaaress, 3� j ��v � S�- �� ,� ��9 t-,� 5 o a 5�
(Addnss) �City} (Zip Code)
(Contaet Person) _1 �a. u �eR (Phone) ��? - qr'� ` �� a�
APPLICANT SIGNATURE DATE - a S' �
APPLICANT PLEASE COMPLETE BELOW
uant� e of Fixture uanti e of Fixture
Bath'I�b with or �vithout shower Rou h-ins
Dishwasher Water Heater
Floor Drain Water So#tener
Lavato Bathroom Sink Stand Pi e Washin Machene
Laund Tra 1 or Z com artment sink Sewa e E'ector
Shower Stail Backflow Assembl
Sinks Backflow Assembt Test
Bar Sink Lawn S rinkier
Water Closet ailet Other
� - FEE SCHEDULE
The Minnesata Statt�tes § 326B .148 � �,{ob c�twith e$49.50 minimum Resident[al, New Ons 8t 1�vaFamily SI49.50
"SURCHARGE'� has been extended '� ttesidentiat, Addi�iaos 8� Aln�io�s a49.s0
� The minimum surchaege fai• a �.
"ftxea fee" permit fs $5.00 $ $uilding Pea�mit #
. PLUMBING PBRMIT FEE $ � � S �
STATB SURCHARGE $ X� 5. 00
TOTAL PERMIT FEE $ �
(Otfice U�e On�y) � • �—'��� /t
Th1s Applicat?on Becomes Your IIuildfng Permit When Approved Paid �- S -� Re ' t No. 7� ��
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Dar��. L �, /�
Butldin¢ o1ric1�! D�te •
24 i�oqr noEice far aq inspectloas (4S2) 447-9850, fax (9S2) 44� 4Z43
A646 Dakota Street S.Ts., Prlor Lake, Mlauaota 55372