HomeMy WebLinkAboutPlumbing Permit #14-081 CITY OF PRIOR LAKE DATE TIOAE
INSPECTION NOTICE SCHEDULED �,l
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ADDRESS �p p ��j� �v � ��
OWNER CONTR.
PHONE NO. PERMIT NO. _ I L I -- 81
0 FOOTING p PLUMBING RI ❑ EX/GRADlFILLING
❑ FOUNDATION � MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE R(
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
O FINAL ❑ PLUMBING FINAL ❑ G SL E AI T
❑ SITE INSPECTION ❑ MECH FINAL
COMMENTS:
0
�S WORK SATISFACTORY, PROCEED
❑ CORR C710N AND PROCEED
❑ COR EC ORK, CALL FOR REINSPECTION BEFORE COVERING
Inspecto : Owner/Contr:
C - 50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODEREQUIREMENTSARE FOR YOUR PERSONAL HEALTH& SAFETY!
INSNOTf
a �. 3�:�� ��-
04 pRj - Date Rec'd
�, CITY OF PRIOR LAKE PLUMBING PERMIT
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�. B��e File pERMIT NO.`�� �
2. Gold Ciry
3. Yellow Applicant
lease or ' t and ' at bottom
ADDRESS ZONING �o�ce ��
Co o� � — ` -!� �-,-�-
LEGAL DESCRIPTION (ofi('ice use anly)
LOT BLOCK ADDITION PID
OWNER ) y � - [
(Name) � ;T /�n % /`� � $ SL'�/j d O l' (Phone)
(Address) " Q � � !�`� � � . Y d h �
APPLICAN / `� �!//
(Name) ✓ � C C (Phone) � � "� Z �` � B T 7"
(Address) 6 L D J` �` �°'c-�-h�_� �-� � / D✓ ii�/ i " f ' ��,�� cv��� � S�
(Address) (City) (Zip Code)
(Conta.ct Person) � � �'�'�' � hone) � �� ^ �� �" 7 `J �
APPLICANT SIGNATURE DATE 4` 1�
APPLICANT PLEASE COMPLETE BELOW
uanti T e of Fizture uanti T e of Figture
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
The Minnesota Statu�es § 326B.14�� FEE SCHEDULE
`" SURCHARGE ° has been extend�t� of job cosc with a$49.50 minimum Residential, New One & Two-Family $149.50
The aninimurrt surcharge for a Residential Additions & Alterations $49.50
"fixed fee" permit is ��ad� �$ Q Building Petmit #
PLLTMBING PERMIT FEE $ ii9fj r�6
STATE SURCHARGE $ —T � .�
TOTAL PERMIT FEE $ ���
�ot�� u� oo�y�
This pplfc Becomes Your Building P mi When Approved Paid %��`� R �pt No� /, /�
U u l4
Date j � B
su officia ate �' � V �
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372