HomeMy WebLinkAboutPlumbing Permit 16-0056 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED -2—
ADDRESS
ADDRESS I " 1 - (A,)
OWNER CONTR.
PHONE NO. PERMIT NO. / (p 5 c,
❑ FOOTING 0 PLUMBING RI tt 0 EX/GRAD/FILLING
❑ FOUNDATION 0 MECH RI 0 COMPLAINT
❑ FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
❑/NSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
❑ FINAL 0 PLUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION 0 MECH FINAL �`
COMMENTS: A
KWORK SATISFACTORY,PROCEED
❑ 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!
INSNOTI
of PR/0,4 Date Rec'd
ti ` `
CITY OF PRIOR LAKE PLUMBING PERMIT
U
jhNESO�
1.Blue pae PERMIT NO.
2. Yell Applicant �C/
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
1`-t i 11 Ati 1 8 5 1�aAA.. 1.1v4 , ria Of t CA-e l M 1J i to 3._1 a
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) Ci m e S CIM CV o 1 QA%;Ne._ N e_v e....tr--1" (Phone) ("<5D)Cl `J -L-45 Jct
(Address) \l,-1\\-1 VJ \6,-S *ash ' N W R ` or t f1.V-f i M N '�3-1 a
APPLICANT
(Name) OW 1 ac On (Phone) S` d L\a' t-1 c►C-1
(Address) UicK AV Y IJ E !" c)k-' 3a
(Address) (City) (Zip Code)
(Contact Person) f► *I (Phone) 3 90"L4 '' - 1 i(-7
/ T
APPLICANT SIGNATURE DATE I /I I1 Lp
APPLICA PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
1 Bath Tub with or without shower Rough-ins
Dishwasher 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
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 -`
Estimated Cost $ ) Building Permit#
PLUMBING PERMIT FEE $ LI ' I .5 0
STATE SURCHARGE $ $1.00
TOTAL PERMIT FEE $ 50 - 6
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid. SR Receipt No3 C 1
Date (,
Dat I
Building Official Date I, ' 7 i t (W By J
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372