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Plumbing Permit 14-1291
DATE TIME CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED k�.-112Iik-c ADDRESS ) L/6 75 'L, n, OWNER CONTR. PHONE NO. PERMIT NO. I / Z ❑ FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING ❑ FOUNDATION 0 MECH RI 0 COMPLAINT ❑ FRAMING 0 WATER HOOKUP 0 FIREPLACE RI ❑ INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL ❑ FINAL 0 PLUMBING FINAL 0 GASLINE AIR TST ❑ SITE INSPECTION 0 MECH FINAL l2 COMMENTS: © IC WORK SATISFACTORY,PROCEED ❑ CORRECT ACTION AND PROCEED ❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING Inspector. C12—at& Owner/Contr. CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY! INSNOTI Date Rec'd Oi1:11)4w CITY OF PRIOR LAKE PLUMBING PERMIT sem I.BlueCity 2. tp PERMIT NO. / Gold A ` � ' 3.Yellow Applicant (Please type or print and sign at bottom) ADDRESS �i I S 1-L� ZONING(office use) �� �15 M d► �� LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID O((NWNER �O'�D L(X)/ <1 •14 A4% 7 13 07 (Address) \Jte01 S Mel\c 1•;0\ S 9r:cY #GCe 1``1v SC 57 APPLICANT G�Q� \ova I�J M(1� (D b' �; 13146 (Name) � \ \ � (Phone) (Address) �'`D10 )o g) al (Address) (City) (Zip Code) (Contact Person) 1 YoI Cr-C (Phone) (OS 1 W05 VS40 __wo.IT.""rAPPLICANT SIGNATURE DATE \ /fI o\a APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough-ins Dishwasher Water Heater Floor Drain Water Softener Lavatory(Bathroom Sink) Stand Pipe(Washing Machine) Laundry Tray(1 or 2 compartment sink Sewage Ejector Shower Stall Backflow Assembly Sinks Backflow Assembly Test Bar Sink Lawn Sprinkler Water Closet(Toilet) Other FEE SCHEDULE 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# �® The Minnesota Statutes§326B.148 "SURCHARGE"has been extended PLUMBING PERMIT FEE $ ACk%t The minimum surcharge for a STATE SURCHARGE $ .50 "fixed fee"permit is$5.00 TOTAL PERMIT FEE This Application Becomes Your Building Permit When Approved Paid •�� eipt No. �] � L Date ( PA Buildine Official Date 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 IF 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372