HomeMy WebLinkAboutPlumbing Permit #14-123 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED
ADDRESS � � � �� I�Q�J �tA� `�'
OWNER CONTR.
PHONE NO. PERMIT NO. ��— ��
O FOOTING O PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
0 INSULATION � SEYVER HOOKUP ❑ FIREPLACE FINAL
O FINAL ❑ PLUMBING FINAL ❑ GASL NE AIR TST
❑ SITE INSPECTION ❑ MECH FINAL �
COMMENTS:
6 .'
� WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ COR CT RK, CALL FOR REINSPECTION BEFORE COVERING
inspecto : Owner/Contr:
C 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTN & SAFETY.�
INSNOTI
o � pgj�� Date Rec'd
�, CITY OF PRIOR LAKE PLUMBING PERMIT 3 �` ��
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,. B�Ue File pERMIT NO_I ���
2. Gold Ciry
3. Yellow Applicant
IC98t Of t SIId S� 8Y b(/iY0111 �
ADDRESS ZONING (ot�ce �se)
� �I r � �
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
(N (Phone) � �� — �7V ° 7�'
(Address)
APPLICANT
(Name) (Phone)
(Address) �� ltt
(Address) , (City) (Zip Code)
(Conta.ct Perso � � (Phone)
APPLICANT SIGNATURE DATE � �
APPLICANT PLEASE CC?MPLETE BELOW
uanti 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 athroom Sink Stand Pi e Washin Machine
Laund 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
The Minnesota Statutes § 326B.14 of job cost with a$49.50 minimum Residential, New One & Two $149.50
"SURCHARGE" has been extended Residential, Additions & Alterations $49.50
The minimum surcharge for a t$ Building Permit #
"fixed fee" permit is �5.00 ,�l
PLUMBING PERMIT FEE $ � «
STATE SURCHARGE $ .�
TOTAL PERMIT FEE $
�ora� u� on�y� ,
This Application Becomes Your Building Permit When Approved Paid S _�� Rece� No. ��C ��/
+ � �r
Baildin¢ Ofticial Date Da� '�(�' � By '
24 6our notice for all inspections (952) 447-9850, faa (952) 447-4245
4646 Dakota Street S.E., Prior Lgke, Minnesota 55372
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