HomeMy WebLinkAboutPlumbing Permit 16-017 DATE TIME
CITY OF PRIOR LAKE Z/I tpINSPECTION NOTICE SCHEDULED I
ADDRESS 2— Ilv-t.--. j ✓ c,1"-I
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OWNER CONTR. `./
PHONE NO. PERMIT NO. 1p. I I 1
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
O FINAL 0 PLUMBING FINAL EytASLINE AIR TST
❑ SITE INSPECTION 0 MECH FINAL .Jr�i
COMMENTS: W v D ka_O
0 -4-0 Cl)k)-1 A.9.__..,
WORK SATISFACTORY,PROCEED
❑ C RRECT ACTION AND PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector.(9Owner/Contr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTI
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�R � 3 L/.(e) Date Ree'd'
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• 'r' CITY OF PRIOR LAKE PLUMBING PERMIT _ /7, (G
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2.(told City PERMIT NO. `/.�s //ij
3.Yellow Applicant / �C ,
Please type or print and sign at bottom)
WDRESS i ZONING Wee
2FEIC gird 16,ke.-- 14--i .
..EGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
Name)R t`?'h-t1 J jam' (Phone) 712-710 -.P
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Address) `?4 ' S Ort h.,$.. tet/14---- M w• 4.6/.1,,,•.. Ilk S-5-3 7L-
LPPLICANT _
;Name) C V k 'Q Tem (Phone) 3 2.0-2.5- 1 2.5 U 5
Address) 32 4 - : .3'
ee 1(t.e.J SU v J i1 W i Pars .pit 0 .5-4 3 '
(Address) (City) (Zip Code)
Contact Person) — —ri 'r (Phone) 310 - 2. S ! -._ .. 5
.PPLICANI`SWNATURE 6t/777-;e1 .r"”" __ DATE
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub With or Without shower Rough-ins
Dishwasher t Water Heater
i Floor Drain Water Softener
.Lavatory(Bathroom Sink) Stand Pipe(Washing Machine)
Laundry Tray(Ior 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 I%of job cost with a$49:50 minimum Residential,New One&Two-Family $149.50
cti Ca)
Residential,Additions&Alterations $49.50
Estimated Cost $ ?f A) Building Permit if
PLUMBING PERMIT FEE $
q' , i?
1 STATE SURCHARGE $ .>O
j TOTAL PERMIT FEE $ •5-0
Dffce Use Only) ,
This Application Becomes Your Building Permit When Approved ' Paid s.3 a Receipt NO. 4 i
Building Official Date Date-2-' 7. /6. By / /
24 hour notice for all inspections(952)447-9850,fax(952)447-4245 .
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