HomeMy WebLinkAboutPlumbing 16-0043 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE .. SCHEDULED
ADDRESS c2/41/11j2 _.______
o r o ;. g' OP
(Dt.>11)
EP
OWNER
CONTR.
PHONE NO. PERMIT NO. / 6 —Oo ,3
❑ FOOTING 0 PLUMBING RI l
❑ FOUNDATION ❑ EX/GR
❑
❑ FRAMINGMECH RI ❑ COMPLAINT
❑ INSULATION 0 WATER HOOKUP 0 FIREPLACE RI
❑ FINAL ❑ SEWER HOOKUP 0 FIREPLACE FINAL
0 PLUMBING FINAL 0 GASLINE AIR TST
❑ SITE INSPECTION 0 MECH FINAL
COMMENTS: i& -ZN- a l-e
I
WORK SATISFACTORY,PROCEED
0 CORRECT ACTION AND PROCEED
❑ COR• AORK,CALL FOR REINSPECTION BEFORE COVERING
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Inspecto . AT Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENT S ARE FOR YOUR PERSONAL HEALTH&SAFETY!
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itiO4 VRIp•R - . Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
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•
soy° I.Brno File PERMIT NO./6
2.GoldAiry
3.Yellow Applicant
(Please type or print and sign at bottom) - -
ADDRESSZONING(office use)
38"8-0 tee v I Pte: .5.53-7 /R /
LEGAL DESCRIPTION(office use only)
LOT ' BLOCK / ADDITION ,eg,, / ( �cZ/ PID ZS-- 386- Df;?`O
OWNERS o. o`` (Phone)507' 37- /15/
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(Name) t�'� _
�
(Address) r (3C m12, —
APPLIC(Name) -1 ,/ Iona_ .d 4 _,/onS (Phone) !�� _ 6)-O 3
(Address) / &&O Che1) Blvd Si'�c C � 553763
53 / /
(Address) (City) (Zip Code)
(Contact Person) t we. K-y� 0 ► -/ (Phone)
APPLICANT SIGNATURE Ii1JN ! i#Ff ' DATE i!Vi I'
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher tiWater Heater
9�
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 -
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 PLUMBING PERMIT FEE $ lelThe minimum surcharge for a STATE SURCHARGE $ / itfi,
"fixed fee"permit isO TOTAL PERMIT FEE $ �
This Application... Becomes Your Building Permit When Approved PaidKQ`S� Receipt No. 3
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1 Date� � By
Buildinc Official Date `
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372