HomeMy WebLinkAboutPlumbing Permit #14-160 DATE TIME
CITY OF PRIOR LAKE �
INSPECTION NOTICE SCHEDULED (' ��l
ADDRESS �-S "! 7 � V� (.�.�Sc, (,,� ����i1-•— I �- .
OWNER CONTR.
PHONE NO. PERMIT NO. � �I — ��..., �
� FOOTING �PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION � MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION O SEWER HOOKUP ❑ FIREPLACE FINAL
❑ FINAL �PLUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION ❑ MECH FINAL ❑
COMMENTS:
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�YIIORK SATISFACTORY, PROCEED
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❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: (,;�,'k-�'--"' OwnedContr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY.�
INSNOTI
Q r�U � Date Rec'd
ti � CITY OF PRIOR LAKE PLUMBING PERMiT �.
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ar� . '
'. B '�` F ''` PERMIT NO. �
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D. Yetlmv AQplicant
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�DR�� ZONING (onice u:e)
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LEGAL DESCRIPTIQN (oflfice use oaty) ,
LOT BLOCK ADbITION pID �
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OwivE�. f\� �l � Q I
(Name) f V ��Tl � N �U � C � (Phone} J � 2 — � `7 b — ` J � J �
(Address) �'1" /� YV ��...�.. vV �f'r�� TI�� �l�- �W
(Name) ANT� 1�. � I"1 EC�fl ti ��) C� 521 `�� "� �%�
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{Address) �- U �' �J , � (,t.) � Q�i.J �� R � � � �
{Address) ._.. (City� •—• (Zip Code} �-•--
(Contact Person) �� J+ IC� � (Phone) �� Z 7 S� ~ g�� �
APPLICANT SIGNATURB DATE 3 I� 1
APPLICANT PLEASE COMPLET� BL�LOW
uanti T e of Fixture Quanti T e of Fixfure
Bath Tub with or without shower Rou h-ins
Dishwasher Water Heafer
1 Floor Drain Water So$ener
Lavato Bathroom Sink SEand Pi e Washi.n Machine
Laund Tra 1 or 2 com artment sink Sewa e E'ector
Shower Stall Backflow Assembi
Sinks Backflow Assembi Test
Bar Sink Lawn S rinkEer
Wafar Closet Toilet Other
Tlte Minnesota StatEites § 326g ,�•¢g job cast with $EE 0�H�DULE ��ident�al, New One 8c'Irvo-Family $149.50
��S���HARGE° has been extended '�� Residential, Additians 8c Alteratio�is $49.50
The t2�it�in�um surcl��►•ge for a '�
"fixed fee" ls �$,QO $ Building Permit #
. PLUMBING PERMIT FEE $ yI �I �`� C�
STATE SURCHARGE $ X� 5 .00
TOTA�L PERMIT FEE $ �j +-� . 5"p
(Offlce C7s� pnly) • •
This Application Becomes Your BufIding Peemlt When Approved Paid�, `� Rec t No. .�/d ��
'7 /
BulldineOFficial Bate Date� �—�, � � By ` �
24 hour notice for a11 inspections (952) 447-9854, tax (952) 447-4245 �
A646 Dakota Street S.E., Prlor Lake, Mlnncsota 55372