HomeMy WebLinkAboutPlumbing Permit #14-125 CITY OF PRIOR LAKE DATE TIME
INSPECTION NOTICE SCHEDULED �_��
ADDRESS _' ��.�-}—� --r� v� —
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OWNER CONTR.
PHONE NO. PERMIT NO. � y��� C�
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❑ FOOTING ❑ PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI O COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION O SEWER HOOKUP ❑ FIREPLACE FINA�
❑ FINAL ❑ PLUMBING FINAL �GAS INE I ST
❑ SITE INSPECTION ❑ MECH FINAL
COMMENTS:
- �IGSQ .
� WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRE K, CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CALL -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL KEALTH & SAFETY.�
INSNOTI
� �
� 4 PR.tp� . Date Rec'd
CITY fJF PRIOR LAKE PLUMBING PERMiT -.
�, � .� . � � .14—
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�f� . .. �
. r. °i°° F��° PERMIT NO.
2, Oald Cily � �—� � ��
3. Yeltrnv Applkant
lease e or rint and st at bottom �
Ann�ss ^ ZfJNING co�r�� ►��
I 5� �q t x Ta� 1 C-}-
LEGAL DESCRII'TI�N (of�'ice use only)
LOT BLOCK ADDITIQN PID
�WNEIZ S G O� N �l U� P�J'� (Phone) �'l So� - �.OS� -��0�'
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(Address) � 5 a (� � �' �C�-�' e, 0 u�! -�-
APPLIC T • � . �
(Name) \ fl s u � l» S (Phone) � S�o. �'I�1' S�'I N�' vP
(Address) ' � � w ' 3 � Q�� � h�� ��� c j
(Address) {City) (Zip Code)
(ContactPerson) �' l � ��' -�r (Phone) ��' ��� 7 ��
APPLICANT SIGNATURB DATE � � L
APPLICANT PLEASE COMPLET� BELUW
uanti e of Ffuture Quanti T e of Fixture
Bath'I�b with or �vithout sl�ower Rou -ins
Dishwasher Water Heater
Floor Drain Water Softener
Lavato BaEhroom Sink Stand Pi e Washin Machine
Laund Tra 1 or 2 com artment sink Sewa e E'ector
Shower Statl Backf�ow Assembl
Sinks Backflow Assembl Test
Bar Sink Lawn S rinkler
Water Claset Toilet Other
The Minnesota Stattttes § 3 26B,1•4$ � joli costwith $E9.5o m�'� Residential, New Ona 8�'Irvo-Fami[y $249.50
��SURCHARGE" has been extended ' � � � [tesideniial, Additions & Alterations $49.50
� The mi►�imam surcharge foi• a �.
"fixed fee" pe;•�31ft ts $5.00 $ Building Permit #
• PLUMBING PERMIT FEE $ � �
STATE SURCHARGE $ �� S . OO
TOTAL PERMIT �EE $ � . S'b
(bfflce Use Qnly) • �
This Appllcation Becomes Your BuUding Permlt When Approved Paid S./ 5 --� Reccip o. �e���
7�
Bulldine O[(icial Date Date� _�� �!� By
24 hour notice for nll inspectlons (452) 447-9850, fax (952) 449-4245
A646 Dnkota Street S.E,, Prlor Lake, Mlancsota 55372