HomeMy WebLinkAboutPlumbing Permit 15. 0525 DATE TIME
CITY OF PRIOR LAKE (.2-17( /INSPECTION NOTICE SCHEDULED (.1..
i ADDRESS � TM7 `.7es-rd. t, ✓
OWNER CONTR. t S` )
13, 1X2. ._ rik—:
PHONE NO. PERMIT NO.
0 FOOTING 0 PLUMBING RI S lit LIT `f c^Y❑ 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 ASLINE AIR TST
❑ SITE INSPECTION 0 MECH FINAL
COMMENTS:
cam _ o_3,--1) e2v-14.---4---v
WORK SATISFACTORY,PROCEED
''0 CORRECT ACTION AND PROCEED
❑ CORRECT K,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!
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`;%.z. LAKE PLUMBING P •ERMIT ERMIT
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!.Gold City EE�e Fitz PERMIT NO. r6^06,ci
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(Please type or print an_,d si8n at bottom) 3.Yellow Applicant
ADDRESS
5747 Crossandra St SE ZONII%(office use)
AUS
LEGAL DESCRIPTION(office use only)
LOT /BLOCK 3 ADDITION 604141-t- e dGe / 5-174Q/eh) PID 5%299- 0 , 0
IOWNER la Clark
(Phone) 952-250-3899
[(Address) 5747 Crossandra St SE
APPLICANT
(Name)
Larson Plumbing Inc
(Phone) 763-427-7680
(Address) 3095 162nd Lane NW
(Address) (City) (Zip Code)
(Contact Person) Kelsy Larson i�
Air
(Phone)
APPLICANT SIGNATURE *��- DATE
_ APPLICANT PLE A SE COMPLETE BELOW
Quantity __ Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher 1Water 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
The Minnesota Stat tttes ___ ,-.-
§32613,14$ (job cost with a$49FEE.50SCHEDULE
"SURCHARGE"has been extended 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 $ 49.50
STATE SURCHARGE $ XXX 5.00
TOTAL PERMIT FEE $ 54.50
(Office Use Only)
This Application Becomes Your Building Permit When Approved aid -/(k Receipt No. I
WOBulldine OfficialDatc
Date � By
6,1/1)
Gik.3____
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.R.,Prior Lake,Minnesota 55372