HomeMy WebLinkAboutPlumbing Permit 14-1175 DATE TIME OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED \Z-3-r`1
ADDRESS 57 7 Y Ze Y,1
OWNER CONTR.
PHONE NO. PERMIT NO. I L) , 11-'5
❑ FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
❑ FOUNDATION ❑ 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 ❑ MECH FINAL
COMMENTS: z" A- r`-,-
0
WORK SATISFACTORY,PROCEED
0 CORRECT ACTION AND PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
Nation
Date Reed
ti, CITY OF PRIOR LAKE PLUMBING PERMIT -E 1 lOzc;
kiNivasoo } s31�e File PERMIT NO.
2.Gold City /4„ 11,7
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS r Z NINcG(eke use)
5118Lx�
LEGAL DESCRIPTION(office use only) L
�vI C ej/ PM(R5^ 3ji -O978.1
LOTI�BLOCK 3 ADDITION /1P.�SS
OWNER Joe-L aKd. Je7yica 14 , H (Phone) t5i 240 75('5.
(N )
(Address) 511 S Le)i ti54O tk C .. L-- U. r to r La tee i
APPLIC(Name)ANTD ra,l a "pro PI u I�-r k q I u c. c152_ 46`t Coq R 9
J — (Phone)
(Address) 8 S i 5 2,0c(-6z4 ,5. - IAL La(«v'111 e 5 5 0 4 4 —
(Address) (City) (Zip Code)
(Contact Person) r a ; (Phone) 5 Z 4FC0 R fo`� 4
APPLICANT SIGNATU DATE 1 0,(7`(4
APPLICA ` PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantic Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher I 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
The Minnesota Statutes§326$.148 {job cost with a$49.50 minimum Residential,New One&'hvo-Family $149.50
"SURCHARGE"has been extended . . ` Residential,Additions&Alterations $49.50
The lllininittn]surcharge for a
$ Building Permit#
"fixed fee"permit is$5,00
.PLUMBING PERMIT FEE $ 461.5 0
STATE SURCHARGE $ XXX 5.00
TOTAL PERMIT FEE $ 54, 50
(Office Use Only)
This Application Becomes Your Building Permit When Approved a Receipt No. 1 95-,,
ate By 2Bulldin¢Official Date (0 110. (�
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.L.,Prior Lake,Minnesota 55372