HomeMy WebLinkAboutPlumbing Permit #14-253 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULEO � 2 �
ADDRESS ,� � � � �� If ���� G �h �
OWNER CONTR.
PHONE NO. PERMIT NO. \ � — � �
0 FOOTING O PLUMBING RI ❑ FJUGRAD/FILLING
� FOUNDATION � MECH RI O COMPLAINT
❑ FRAMtNG ❑ WATER HOOKUP 0 FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
O FINAL O PLUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION ❑ MECH FINAI �
COMMENTS: L���-�-- � -�� ,,
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�ORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector. OwnedContr.
CALL 447-8850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
GODE REQUIREMENTSARE FOR YOUR PERSONAL KEALTH dc SAFETYt
uvsHOn
� 4 pRlp� . Date Rec'd
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CITY OF PRI4R LAKE PLUMBING PERMIT �
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a'�vesa�s� .. ,. a��G F��z PERMIT NO. L
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3. Yello}v Applicant � d.
lease e or rint aad sI at Uottam
ADDRESS ZO G (of�ice use)
5443 FAWN MEADOW CURVE SE PRIOR LAKE, MN 55372 �
LEGAL DESCRIPTI4N (oflf�ice use only)
I,OT BI,OCK AD3�ITION PID o� '�! /'� Cy
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Q� R STEPHANIE SCHiJMACHER & MICHAEL MARTIN (phone) 612-481-2717
ame
(Address) 6204 SOUTH PARK DRIVE SAVAGE, MN 55378
APPLICANT
(Name) STEPHANIE SCHUMACHER & MICHAEL MARTIN �,��� 612-481-2717
(Address) 6204 SOUTH PARK DRIVE SAVAGE, MN 55378
(Address) (City) {Zip Code)
STEPHANIE SCHUMACHER 612-481-2717
(Contact Person) (Phone)
APPLICANT SIGNATURE DAT�
APPLTCANT PLEASE COMPLET� B�LOW
Quanti T e of F`ixtt�re Quauti T e of Fixture
Bath Tub witli or without shower Rou h-ins
Dishwasher Water Heater
Floor Drain 1 Water Softener
Lavato Bathroom Sink Stand Pi e Washin Machine
Laund Tra 1 or 2 com artrnent si��k Sewa e E�ector
Shower Stall Backflow Assembl
5inks Backflow Assembl Test
Bar Si�k La�vn S rinkler
Water Claset ToiEet Other
Ttte Minilesota Stat«tes � --- - FEE SCH�DULE
§ 3 26$.1'Q.8 j joli cost wi#It a�4950 minin�um Residential,lVew One & Two $149.50 I
�� SURCHARGE ° ]�as ���t� extenc�ed ttesiaentiat Additions & A3teratiot�s �49.50 i
T�IL 1] IIII[I1ltittl SUI •c}��i�g� #'or a ' .
"fixed Pee" pe��tnft is � Building Parmit # �
��.oa � s �
. PLUMBING PERMIT FEE $
STATESURCHARGE $_ X�� �.00
TOTAL PERMIT �EE $ + ��SU
(afGce Use Only) -
This Appiication Becomes Your Building Pernxit When Approved Paid �'� � Receipt Na n � I
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Date r12 I By �
,
BuOdine OF(tclal Datc CX7
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24 l�our notice for nll inspections (452) 447-9854, fax (952j d4'7-4245
.4645 Dalcota Street S.C., Prior Lake, Minnesota 55372
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