HomeMy WebLinkAboutPlumbing Permit 15-0207 CITY OF PRIOR LAKE 5/DATE TIME
INSPECTION NOTICE SCHEDULED 5/(. /t
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ADDRESS 3S 8
OWNER CONTR.
PHONE NO. PERMIT NO. IS- &01
❑ 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 ❑ GASLINE IR TST
❑ SITE INSPECTION 0 MECH FINAL 14124
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COMMENTS:
C-1-(05-e c,
7 WORK SATISFACTORY,PROCEED
0 CORRECT ACTION AND PROCEED
0 CORRECT ' - CALL FOR REINSPECTION BEFORE COVERING
Inspector. Owner/Contr.
CALL 7 .50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
Ci S REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
NNSNon
PRtp4 Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT 3 /0./c
447ase
I.2.cold City PERMIT NO.
3.Yellow Applicant ��•
(Please type or print and sign at bottom)
,ADDRESS ZONING(of ice use)
c ye' C
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER ���
(Name) �- (Phone) 7(03--- 7---3k//
(Address) C. f / a+4'Ji
{Name)
APPLICANT &1 (�„ 9-CU Zito ,6 (Phone) (r& � 1/1-r--
(Address)
(Address) `�� y2 Oahe_ /�(/`e 41-
(Address) (City) (Zip Code)
(Contact Person) 64�Jj_ (Phone)
APPLICANT SIGNATURE g1 /�ik'2 DATE 3_L"C.
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 f 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
The Minnesota Statutes§326B.148 $ Building Permit#
"SURCHARGE"has been extended
The minimum surcharge for a 'LUMBING PERMIT FEE $
"fixed fee"permit is$5.00 ;TATE SURCHARGE $ .50
COTAL PERMIT FEE 4P-1/
This Application Becomes Your Building Permit When Approved Paid - S per No. 79,/
Date._ /' 1�
Buntline Official r Date
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372