HomeMy WebLinkAboutPlumbing Permit 13. 1125 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 3/N1 /
ID
ADDRESS 4zs- CNtRAi •
OWNER _ CONTR. 1,3 -U�2
PHONE NO. PERMIT NO. 1S- (, o
❑ 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 ❑ GAS INE AIR T T
❑ SITE INSPECTION -MECH FINAL o Walla Elk C
COMMENTS: fLL,,.,a L 4 frr�
4Ja •e r 4-1"tr
Nose_ C2) Qs
AL '..)09- Z to ,
WORK SATISFACTORY,PROCEED
O CORRECT ACTION AND PROCEED
❑ CORRECT ,CALL FOR REINSPECTION BEFORE COVERING
Inspector. Owner/Contr.
CALL - 850 R THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTI
"4"01
CITY OF PRIOR LAKE PLUMBING PERMIT Date Recd
/0 • �t - /.3
.
Blue Fi
Gold Cityle I� �,
or t and si_, at bottom 3. Yellow Applicant
ease 2. I 11/11M
ADDRESS
4/357 �'Ar2 ZONING(office use)
LEGAL DESCRIPTION(office use only)
LOT BLOCK / ADDITION / / i AI 3
OWNER "�Jfi2 _"/
.
(Name) / go i/ f e4 _
A i` (Phone) tJr' o�- �
(Address)
APPLICANT
(Name)
(Address)
Affiance Connections Inc. (Phone)
(AddreShako, MN 55379 (City)
(Contact Person)
952-445.4803 (Zip Code)
(Phone)
APPLICANT SIGNATURE S - i
DATE /°
APPLICANT PLEASE COMPLETE BELOW
T ,e of Fixture
IMMTEEIMIIIIIIIIMIIIIIII Bath Tub with or without shower 1 T e of Fixture
Dishwasher 111111M1111Rou:h-ins
Floor Drain
IIIIIIIIIIMIIMILavato Bathroom Sink Water Softener
Laund Tra 1 or 2 com.artment sink ■ Stand Pi.e Washin: Machine
_- Shower Stall Sewa:e E'ector
Backflow Assembl
Bar Sink Backflow Assembl Test
IIZMM
Water Closet Toilet MTIIIIImnnmnm
Other
The Minnesota Statutes§3268.148 FEE SCHEDULE
"SURCHARGE"has been extended ,fjob cost with a$49.50 minimum Residential,New One&Two-Family $149.50
Residential,Additions&Alterations $49.50
The minimum surcharge for a
"fixed fee"permit is$5.00 $ Building Permit#
PLUMBING PERMIT FEE $ So e___,
STATE SURCHARGE $ .50
(Office Use Only) TOTAL PERMIT FEE $
This Application Becomes Y 1 i r Building Permit When Approved !'+
6 Vail 1 •
Buildine Official 4 Date b ate
0 � << By —��
24 hour notice for all inspections(952)447-9850,fax(952)447-4245 .111111.
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372