HomeMy WebLinkAboutPlumbing Permit #13-1392 DATE TIME
CITY OF PRIOR LAKE
INSPECTfON NOTICE SCHEDULED � � I
ADDRESS f � / � � ��
OWNER CONTR.
PHONE NO. PERMIT NO. /�,� --� r� C � z^
❑ FOOTING 0 PL.UMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION � MECH RI ❑ COMPLAINT
❑ FRAMtNG ❑ WATER HOOKUP ❑ FIREPLACE Rt
� NSULATION 0 SEWER HOOKUP ❑ FIREPLACE FINAL
INAL O PLUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION O MECH FlNAL ❑
COMMENTS:
� s ��
� ORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT W , GALL FOR�EINSPECTION BEFORE COVERING
1 �
�,�/� �
Inspector: ' � � �� � `'�.-L-' �nedContr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 NOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
� I Q - �5�-- � 2,
4 pRlp - Date Rec'd
,� � CITY UF PRIOR LAKE PLUMBING PERMIT �.
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�'�s��' . _ ' --
�6'1 i: aa a �� PERMIT NO. � I��
3. Yellrnv Applkant
isase e or rint and s at bottom
ADDRE$S � UC I� �C ��� S � I`-� � ZON]NG corr,ce uu)
LBGAL DESCRIPTION (off'ice use only) ,
LOT BLOCK ADbITIQN PID `
r � L c Ccj
(JWNL+R �V e. �.1 1�� {Phone) J�" S'° � J J 1
ame
(Address) � �Q t L` � ��. �
APPLICANT < J �1
(Name) � t (Phone) J� ^ �� l Ov
(Address) W � l� � S V Uc � S J 3
( ddress) (City) (Zip Code)
(Contact Person) ��- � (Phone) � ✓ Z ` �� � � V �
APPLICANT SIGN�TURB ��'����►`� DATB Z I� �"
APPLTCANT PLEASE COMPLET'� BELOW
uanti T e of Ff�sture Quantt T e of Fixture
Bath 'Ibb with or �vitheut shower Rou h-ins
Dishwasher Water Heafer
Floor Drain Water Softener
Lavato Bathroom Sink Stand Pi e Washin Machene
Laund Tra 1 or 2 com artment sink Sewa e E'ector
Shower Stail Backflow Assembl
Sinks Backflow Assembl Test
Bar Sink Lawn S rinkler
Water Closet Toilet Other
Tl�e Minnesota Statates § 3268 .1'48 � joa cost with �E9.50 minHmm� Residential, Ne►v Ona &'ri�vo-Feaiity $144.50
' � SURCHARGE" has been extended �'� f Residential, Additions dt Altc�ationa $49.50
• The mii�intum surch�rge for a '.
"fixed fee" pe�•�lit 1s $5.00 $ Building Permit #
. PLUMBING FBRMIT FEE $
STATB SURCHARGE $ S . OO
TOTAL PERMIT FEE $
(UfYice Use Only) . .
This Appliea ecomes Your Building Permit When Approved Paid� / L S Rcce No.
L � ( �t � �— Date `' BY
Bul Ofltclsl bate ` E
i
24 hour notice for all inspecUons (95Z) 447-9850, f�x (952) A4'1-4245
A646 Dakota Street S.E., Prfor Lake, Mlnneaota 55372