HomeMy WebLinkAboutPlumbing Permit #14-168 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED �
ADDRESS (p ,� � � �-
OWNER CONTR.
PHONE NO. PERMIT NO. ! y, �(•��
❑ FOOTING ❑ PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION O SEWER HOOKUP ❑ FIREPLACE FINAL
O FINAL ❑ PLUMBING FINAL _ O, G/1$LIN�.AtR�ST
❑ SITE INSPECTION ❑ MECH FINAL 7d �,�J.4J C
COMMENTS: ��
�WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspedor: C�'K� l�'v ✓ OwnedContr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH dc SAFETY!
lNSNOTI
- ' pitlQ� Date Rec'd
�, CITY OF PRIOR LAKE PLUMBING PERMIT
ti �
v
�� i Blue Fde pERMIT NO • /
2. Gold City / /�
3. Yellow A�'licant / �� /�(/ �
lease or ' t and s' at bottom
ADD$ESS ZONING (oteice use)
I � �� ����.r � ' w
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
�aWNER , �l� � (Phone) 1 � � � � / V � �/ ��
, n � � / 1
(Address) r� ��� �,(,�,� �' Y/ J� O'
APPLICANT /'� / ,,� _ - �j �
(Name) l�f'�G �� � � 1� 1(,ZkYI ✓'1 �� (Phone) � � - 3�5 - f ��
2 �► {� � � �V �
(Address) J�G�I� ,��� 1" • �-� l � �
ddress) (City) (Zip Code)
(Contact Person) hone) 4��� `�� �I =-�`T �
APPLICANT SIGNATURE DATE � -�� ���
APPLICANT PLEASE COMPLETE BELOW
uanti T e of Fixture uanti T e of Fixture
Bath Tub with or without shower Rou h-ins
Dishwasher 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 Assembl Test
Bar Sink Lawn S rinkler
Water Closet Toilet Other
FEESCHEDULE
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 #
'Tf�e Mistt��sata Statutes � 326Bo14�3 � ,g� ��
"'SUkt��-�ARi�E" has b��n extendec3 PLLJMBING PERMIT FEE $ �f
'�'he YY3iraimuc�� surchar�;e far a STATE SURCHARGE $ � 4�SV'
"fixe�j fee�' permit is ��a�� TOTAL PERMIT FEE $ �l-('_ S=�
This Application Becomes Your Building Permit When Approved Paid J ��-��� Re eipt No. rl�� �5 S
Date ,
Buildine Oftcial Date � ' �� � � '
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 ��
4646 Dakota Street S.E., Prior Lake, Minnesota 55372