HomeMy WebLinkAboutBuilding 15-0110 DATE TIME
CITY OF PRIOR LAKE (2 ,Z.f/C0 INSPECTION NOTICE SCHEDULED (
ADDRESS i q 31G,C2 (SU-43 re. l
OWNER CONTR.
PHONE NO. PERMIT NO. 1 5 "(1 C.
❑ 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 0
COMMENTS: (,) ,-- SeD-t-t— -
Q\6 D 1-, Ce
XWORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRE RK,CALL FOR REINSPECTION BEFORE COVERING
Inspector 2Owner/Contra
CAL -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
UiSNOTI
04 rod Date Rec'd
6 CITY OF PRIOR LAKE PLUMBING PERMIT -
d' so*
2.Gtud aCPERMIT NO /5 /`D
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS
ZONING(office use)
06/a. , 4 If C -- Dr-.
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
t I, , z
(Name)( h,. � )& J
- 5-80s
(Address) ((43 A) (S he V Cz Cct Pr.
APPLICANTANT-7) C � rA n Ce (Phone) 7k.,,-3 (h (--R--(/
ame (,� J' ] ,/j l`tr f V '1 i, - 1 j �`�(��
(Address) a0 1 CQU r 17-61 q (AlL(I y i i e 25.�37
�� n(Address) !n�/ (City) (�? (Zip Code)
(Contact Person) ,XJ3 -P V iV e ( (Phone) qN- "`J�- 3"( `'Ca
APPLICANT SIGNATURE , j DATE
1/3(/I
/
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 1 Water Softener
Lavatory(Bathroom Sink) Stand Pipe(Washing Machine)
Laundry Tray(1 or 2 compartment sink Sewage Ejector
Shower Stall , Backflow Assembly
-
SinksBackflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet(Toilet) Other
The Minnesota Stattites _.___ _ FEE SCHEDULE
§326B.1'48 E job cost with a$49.50 minimum Residential,New One&Two-Family $149.50
"SURCHARGE"has been extendeci . ' Residential,Additions&Alterations $49.50
The minimum surcharge for a ' .
"fixed fee"permit is$5,00 $ Building Permit#
PLUMBING PERMIT FEE $ Lig' 0
STATE SURCHARGE $ XXX 5.00
TOTAL PERMIT FEE $ 91. S 0
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid 5�,/. 0) Re ipt No. (0. 1
y`'
Date2 ,/, is
Building Ofliciat Date `�,
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372