HomeMy WebLinkAboutPlumbing Permit #14-218 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED � 2S !
ADDRESS � �� a, �rj !�� L l/� ,
OWNER CONTR.
PHONE NO. PERMIT NO. � �"�. -" ���
� FOOTING O PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
O FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION O SEWER HOOKUP O FIREPLACE FINAL
O FINAL ❑ PLUMBING FINAL ❑ GASL INE AIR T T
❑ SITE INSPECTION O MECH FINAI �
COMMENTS:
�52.
� WORK SATISFACTORY, PROCEED
� CORRECT ACTION AND PROCEEO
❑ CORREC RK, CALL FOR REINSPECTION BEFORE COVERING
I�spector. OwnedContr:
CALL 44 -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH dc SAFETY!
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� 4 pRj�� Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
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,. B�ue File pERMIT NO. �, f
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l. Yellow Apphcant ( �
lease or ' t and si at bottom
ADDRES� ��� � � L f � ZONING (otsce use)
1 r� �=1�? � E
LEGAL DESCRIPTION (oflflce use oniy)
LOT BLOCK ADDITION PID
OWNER �
(Name) (Phone)
(Address) � �
APPLICANT ��P��� ��
(Name) Ptw 000308 (Phone)
(Address) ��� ���'� ��
(Address) 3 �a (City) (Zip Code)
Ea n, M N 55123
(Contact Person) � (Phone)
APPLICANT SIGNATURE � DATE ` � � �`
APPLICANT PLEASE COMPLETE BELOW
Quanti T e of Fixture uanti T e of Fixture
Bath Tub with or without shower
Dishwasher e r
Floor Drain Water So ene
Lavato Bathroom Sink n 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, Commerciai & Multi-family 1% of job cost with a$49.50 minimum Residential, New One 8c Two-Family $149.50
Residential, Additions & Alterations $49.50
Estimated Cost $ � Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $ � �
TOTAL PERMIT FEE $ �,
(Oftice Use Only)
This Application Becomes Your Building Permit When Approved Paid ��� Re�eipt No./1 �� �, —�'
� 1 5
Date By
Buildin¢ Officisl Date "( - � � < <
na `'
24 6our notice for all inspections (952) 447-9850, fax (952) 447-4245 �,\
4646 Dakota Street S.E., Prior Lake, Mianesota 55372
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