HomeMy WebLinkAboutPlumbing Permit 15-0124 DATE TIME
CITY OF PRIOR LAKE SCHEDULED z-I .5—INSPECTION NOTICE
ADDRESS 3 LI L-„'I"`'''
OWNER
CONTR.
,
2 �
PHONE NO. PERMIT NO.
p FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
❑ FOUNDATION 0 MECH RI 0 COMPLAINT
p FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
0 SEWER HOOKUP 0 FIREPLACE FINAL
p INSULATION• FINAL PLUMBING FINAL 0 GASLINE AIR TST
❑ SITE INSPECTION ECH FINAL 0
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COMMENTS:
I,&-
0 14-
p
WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
O CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector. Owner/Contra
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
,NSNOTI
Oi pRtO� Date Recd
CITY OF PRIOR LAKE PLUMBING PERMIT 0 ,i, 1.�"
v
°�� :B'"` F1 e PERMIT NO./S--- --
3.
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3. Applicant iii"'
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
3e9 1/3 7--,,,,,,_ )-3, .
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) (Phone)
(Address)
APPLICANT 47)0�� d-4AOkij (P ) (t//2-'I 7 ff'G hone
(Address) cZ.Vi ( i J / Al ( 7V-e(.t l //T/p-€' s?-1/.kr
(Address)
ZL-
(Address) (C' ) (Zip Code)12.1-(Contact Person) Jo (Phone) C{/2 �fr
a i 1/9r
APPLICANT SIGNATURE �� DATE 2 -/-X5----
APPLICANT
/JJ5APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain 1 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 $4950
'^ Building Permit#
The Minnesota Statutes§3268.148
"SURCHARGE"has been extended .UMBING PERMIT FEE $
The minimum surcharge for a CATE SURCHARGE $ .50
"fixed fee"permit is$5.00 DTAL PERMIT FEE $ V-
This Application Becomes Your Building Permit When Approved Paid514 kr.'* Re ipt Nott, 55L-_-1
/ B
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Building Official Date Date,„ ” L (s ✓
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372