HomeMy WebLinkAboutPlumbing Permit #14-142 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED `-S . 2� � ' �
ADDRESS ��. 7,� 4`�1 / C.=.�✓ � `- l�
OWNER CONTR.
PHONE NO. PERMIT NO. ! �� - � `�` � �"
� FOOTING O PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI O COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION O SEWER HOOKUP ❑ FIREPLACE FINAL
O FINAL ,� PLUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION � O MECH FINAL ❑
1 . _ +,- a ; ;' - , _
COMMENTS: , { r , F° 4 f, ,_ � � � � c J �__ .
%
�
��, WORK SATISFACTORY, PROCEED
❑ G''ORRECT ACTI,�N AND PROCEED
t�
❑ CORRECT WO �, LL FO REfN ORE COVERING
Inspector: �
_.... _ ....�----
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY!
/NSNOTI
O � YRIp� Date Rec'd
�, CITY OF PRIOR LAKE PLUMBING PERMIT
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,. B '°` F ''` pERMIT NO �
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3. Yellow Applicant
lease ar' t and s' SY bottOm
ADDRESS ZONING �o�re ��
�g 35 �,J �� � � �_ �l �S 3 � �
LEGAL DESCRIPTION (oflCice use only)
LOT BLOCK ADDITI0IV pID
OWNER ,
�� �ero rn� � c�� � N O -�j l�.s� (Phone) 9'Sa � y 4 5- 3 I U �
(Address)
APPLICANT CU�LiGAN 1NATER �;O�t7ITId�lIl�G (Phone)
(Name) .i� �L! ,t'.�x��9 i/'J��
(Address) �111iV6V1�TU�lE<A, iV1i�! 55�45
(.�,S��ss�:3�-7�0� (City) (Zip Code)
(Contact Person) (Phone)
APPLICANT SIGNATURE DATE .3— � - � �-}
APPLICANT PLEASE COMPLETE BELOW
uanti T e of Fizture uanti T e of Fixture
Bath Tub with or without shower Rou h-ins
Dishwasher Water Heater
Floor Drain Water Softener
Lavato Bathroom Sink Stand Pi e Washin 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
FEE 5CHEDULE
Industriat, Commercial & Multi-family 1% of job cost with a$49.50 minimum Residential, New One & Two-Family $149.50
Residenrial, Additions & Atterations $49.50
, The Minnesota Statutes § 326B.148 \
"SURCHARGE" has been extended $ 1`�Ou , p V Building Permit #
The minimum surcharge for a
PLUMBING PERMIT FEE $
"fixed fee" permit is $5.00 STATE SURCHARGE $ .50
TOTAL PERMIT FEE $ S�f , 5�
(Oftice Use Only)
This Application Becomes Your Building Permit When Approved Paid �-� 5 -� Receipt No. •7 U �� f
Buitd�ne oittcjai Date Date `3 ' ��' �,� BY .
24 haur notice for all ➢nspections (952) 447-9850, fag (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372