HomeMy WebLinkAboutPlumbing Permit #14-124 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED � I ��
ADDRESS �' — �j �� 1 (J c^�;J1 �—'�'
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OWNER CONTR. �
PHONE NO. PERMIT NO. � ��'� ' � �'`�����
❑ FOOTING ❑ PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FiNAL
� FINAL � PLUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION ❑ MECH FINAL ❑
COMMENTS: ;"- --,.-.
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[�• WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
O CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
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Inspector �_- �_� ;J �....- Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY.�
/NSNOTI
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F CITY OF PRIOR LAKE PLUMBING PERMIT �; � �,�
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�. B��e File pERMIT NO. I
z. co�a c�ry
3. Yeliow Appficant �
288t OT � t 871(} � 2t �10Lt011l
ADDRESS ZONING �ot��,��
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LEGAL DESCRiPTION (office use onty)
LOT BLOCK ADDITION PID
OWNER �
(Name) (Phone)
(Address)
APPLICANT
(Name) pp,�liance Co4�r�ecti�g,:�:nc (phone)
12850-� �e� 5379
(Address)
(Addre (City) (Zip Code)
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(Contact Person) (Phone)
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APPLICANT SIGNATURE � DATE
APPLICANT PLEASE COMPLETE BELOW
uanti T e of Fixture uanti T e of Figture
Bath Tub with or without shower Rou h-ins
Dishwasher Water Heater
Floor Drain Water Softener
Lavato Bathroorn 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 SCHEDULE
'^''"°''`'' "� o of 'ob cost with a$49.50 minimum Residential, New One 8c Two-Family $149.50
The Minnesota Statutes § 326B.148 � Residentiai, Additions & Alterations $49.50
"SURCHARGE has been extended
The minimum surcharge for a st $ Building Permit #
"fixed fee' permit is �5.00 �\
PLUMBING PERMIT FEE $ � - .J v
STATE SURCHARGE $ �
TOTAL PERMIT FEE $
tom� u� op�y� -
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This Application Becomes Your Building Permit When Approved Paid � V I y S —� R eipt No. � U G I A,
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Date� i �✓�
Buildin� Official Datc � •
24 hour not3ce for all inspections (952) 447-9850, fax (952) 447-4245
464b Dakota Street S.E., Prior Lake, Minnesota 55372
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