HomeMy WebLinkAboutPlumbing Permit #14-122 OATE TIUAE
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED � 3 ��_
ADDRESS (^ � � � �
OWNER CONTR. �--
PHONE NO. PERMIT NO. I�I' `' � ZZ
❑ FOOTING O PLUMBING RI O EX/GRAD/FILLING
❑ FOUNDATION � MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
0 INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
❑ FINAL LUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION �ECH FINAL ❑
COMMENTS:
.�.��r ��
�ORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
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Inspector: Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY.�
lNSNOTI
�4 p�0� Date Rec'd
� CITY OF PRIOR LAKE PLUMBING PERMIT �� � (�
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LEGAL DESCRiPTION (office use onty)
LOT BLOCK ADDITION pID
(N W�NER (� � � L-1.v► � � (Phone) ! �XJ` �U `�� �
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(Address) � � � �-�
(NameC� �p m�'+pie� �lu�bing
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PC 000308
(Address)
(Addres Dodd Road - (cl�y� (Zip Code)
(Contact Person) (Phone)
APPLICANT SIGNATURE a DATE '
APPLICANT PLEASE COMPLETE BELOW
uanti T e of Fixture uanti T e of Fizture
Bath Tub with or without shower Rou h-'
Dishwasher at r Heater
Floor Drain ener
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 SCHEDULE
Industrial, Commercial & Multi-family 1% of joh cost with a$49.50 minimum Residential, New One & Two-Facnily $149.50
Residenrial, Additions & Alterations $49.50
� ,�f��� °" Building Permit #
The Minnesota Statutes § 326B.148
"SURCHARGE" has been extended PLUMBING PERMIT FEE $
The minimum surchalge for a 5TATE SURCHARGE $ 50
"fixed fee" permit is �5.00 TOTAL PERMIT FEE $ �
_
This Application Becomes Your Building Permit When Approved Paid � S-u Recei o. '� � C� (�
Date ..� � � � � By
sU�a�g om��� nac� .� , �
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesot� 55372 ��
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