HomeMy WebLinkAboutPlumbing Permit #14-056 DATE TIME
CITY OF PRIOR LAKE }/
INSPECTION NOTICE SCHEDULED � I — 1 7
ADDRESS � � J ��
OWNER CONTR. ;��tiU �� � v
PHONE NO. PERMIT NO. � y• 1, J�` ��•�
0 FOOTING 0 PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
0 FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
❑ FINAL �LUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION � ECH FINAL ❑
COMMENTS:
�/
���ORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
� CORRECT W K, CALL FOR REINSPECTION BEFORE COVERING
Inspector. OwnedContr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOT)
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� Q p RIp� � _ Date Rec'd
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CiTY OF PRIOR LAKE PLUMBING PERMIT �.
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. �. �'"` �'� PERMIT NO.1l�, S�o
a aow c�ti
3. Yelbrv Apyllant
Iease e or rint and s at bottom
.ADDRESS ZONII�IG (ot6« nce)
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LBGAL DESCRI.PTION (oflficc ust onty) .
LOT BLOCK ADT3ITiON PID ;
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owivE� I Z- �C� � Zg(p � �
(Name) l m � {Phone) ��
(Address) I l, l " �, �
At'PLICANT � _ � Z�� l Il�' � �J
(Name) (Phone)
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(Address) � � � � �!�-- S S 3
(Aaaress) (ciry) (zip coae)
(Contact Person) � (Phone)
APPLICANT SIGNATURB DATB 3 �
APPLICANT PLEASE COMPLET� BELOW
uanti T c of Fiuture Quanti T e of Fixture
Bath T�ub with or wi#hout shower Rou h-ins
Ds'shwasher Water Heater
Floor Drain Water Softener
Lavato Bathroom Sink Stand Pi e Washin Machine
Laund Tra 1 or 2 com artment sink Sewa e E'ector
Shower Stall Backflow Assembl
Sinks Backflow Assembi Test
Bar Sink Lawn S rinkler
Water Closet oilet Other
The Minnesota Stati�tes § 32GB ,1¢g � j� � �� $EE 4�H'EDULE Residemial, New Ona &'ri�o-Namily $149.50
"SURCHARGE" has been extended � � � � �
Residentiai, Additions dt Altecations $49.50
� The minintum surcharge for a '
"fixed fee" pernift ls $5.00 $ Building Permit #
� PLUMBING PBRMIT FEE $ / , S �
STATB SURCHARGE $ 5 . 00
TOTAL PERMIT FEE $ S. S
(Ofdce U�e Ou1y) . -
Th[s Applicatloa Becomes Your Buflding Permit When Approved Paid �j �--� ipt No. ��� Z�
Date � y 2 1 � j, B
BuOdin¢ Offtclei IIpte �'��
24 hour notice for all ln:pccdons (952) A47-9850, inx (952} q47-d24S
A646 Dakota Street S.E., Prior Lake, Mlnncsota S537Z