HomeMy WebLinkAboutPlumbing Permit #14-145 DATE TIAAE
CITY OF PRIOR LAKE ,� ����
INSPECTION NOTICE SCHEDULED `"� �3 ���,}
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ADDRESS � ( � �' � I T�,�- � � r
OWNER CONTR.
PHONE NO. PERMIT NO. _�+-� — ���j
❑ FOOTING 0 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 ❑ MECH FINAL ❑
COMMENTS:
/❑ �ORK SATISFACTORY, PROCEED
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❑ 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.�
INSNOTI
O4 pRlp� , Date Rec'd
F CITY OF PRIOR LAKE PLUMBING PERMIT � 2 � l L�—
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. i. Blue File pERMIT NO `
2. Gold City / /
3. Yellow Applicant • • � r (
lease or ' t aad ' at bottom
ADDRES�� � � , ZONING (ot�'ice �se)
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LEGAL DESCRIPTION (office use onty)
LOT BLOCK ADDITION PID
OWNER ` /� Q (�
(Name) W (Phone) - I� � { �� � ��i�
(Address) <_��%`/�1�v ��
APPLICANT Chsmplon Plumbing
(Name) (Phone)
(Address) 651-3Fi5-1340
(Address) 3670 Dodd ROad (City) (Zip Code)
� n MN 55123
(Conta.ct Person) �� � � � (Phone)
APPLICANT SIGNATURE � DATE � I T��
APPLICANT PLEASE COMPLETE BELOW
uanti T e of Fixture uanti T e of Fiature
Bath Tub with or without shower
Dishwasher Water Heater
Floor Drain Water o ener
Lavato athroom 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 job cost with a$49.50 minimum Residential, New One & Two-Family $149.50
Residential, Additions & Alterations $49.50
st $ �•� Building Permit #
The Minn`esota Statutes § 326B.148
"SURCHARGE" has been extended PLLJMBING PERMIT FEE $
The minimurn surcharge for a STATE SURCHARGE $ .50
'°fixed fee" permi.t zs �5.�10 TOTAL PERMIT FEE $
This Application Becomes Your Buitding Permit When Approved Paid �,/ 5 � R pt No. � �� <;�
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Date � Z f . �3
suua�ne otr�iAi nace '
24 6our notice for ali inspecnons (952) 447-9850, fag (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Mianesota 55372 „ n
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