HomeMy WebLinkAboutPlumbing Permit #14-153 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 3 I
ADDRESS ��Q � F.J � �L'ik•�"�-Z� ' l (IC�
OWNER CONTR.
PHONE NO. PERMIT NO. � � „ � � �
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� FOOTING � PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
O FINAL O PLUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION O MECH FINAL ❑
COMMENTS:
/�'�VORK SATISFACTORY, PROCEED
�
' ❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
1
Inspector. � �< � � Ovvner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL KEALTH & SAFETY.�
lNSNOTI
0 � p Wp� Date Rec'd
a� CITY OF PRIOR LAKE PLUMBING PERMIT
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�. B�ue File pERMIT NO. /
2. Gold City �� `��
3. Yeliow Applicant
lease or ' t and si at bottom
ADDRESS ZONING �ot�ce ��
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LEGAL DESCR�TION (offece use only)
LOT BLOCK ADDITION pID
(Na�ine) R 1� � / � (Phone) " � l.li
(Address) v
APPLICANT
(Name) (Phone)
(Address) 1a�0 ChGStntl� BIVd.
(A res 52 _4 � -4$�3 (City) (Zip Code)
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(Conta.ct Person) ' (Phone)
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APPLICANT SIGNATURE DATE
APPLICANT PL ASE COMPLETE BELOW
uanti T e of Fixture uanti T e of Fixture
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
--`-' °� '`°'`' r ` - �' - � '°' of job cost with a$4950 minimum Residential, New One & Two-Family $149.50
The Minnesota Statutes § 326B.148 Residential, Additions & Alterations $49.50
"SURCHARGE" has been extended
The minimum surcharge for a �t $ Building Permit #
"fixed fee" permit is $5.00 pLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
�om� u� oo�y� f �
This Application Becomes YourBuilding Permit When Approved Paid s ,S-(� Recei No.� G,L�
. 7 -�
Date � � s � ( � By
Bnildiaa Official Date � • -
24 6our notice for �11 inspections (952) 44�-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prlor Lake, Minnesota 55372
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