HomeMy WebLinkAboutPlumbing Permit 16-0033 DATE TIME
CITY OF PRIOR LAKE SCHEDULED 3
INSPECTION NOTICE
ADDRESS 1Sa� _ -
OWNER CONTR.
PHONE NO. PERMIT NO. .16C-___ —_
0 PLUMBING RI 0 EX/GRAD/FILLING
❑ FOOTING0 MECH RI 0 COMPLAINT
❑ FOUNDATION 0 WATER HOOKUP 0 FIREPLACE RI
❑ FRAMING 0 SEWER HOOKUP 0 FIREPLACE FINAL
lig❑ INSULATION 0 PLUMBING FINAL 0 GASLINE AIR TST
ITEL MECH FINAL 0
O SITE INSPECTION Q,, �• ,Q._ �lu ��'
COMMENTS
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❑ WORK SATI ACTORY,PROCEED
[ CORREC'A• IL, AND PROCEED
11
0 CORRE'T O' ,C 4' FOR REINSPECTION BEFORE COVERING
Inspector. rr Owner/Contra
CALL -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTI
p4 PRI04, Date Rec'd
ti 1 CITY OF PRIOR LAKE PLUMBING PERMIT ,S�
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*NBSO�
L1e� ple PERMIT NO./ �ao
3.Yellow Applicant /
(Please type or print and sign at bottom)
ADDRESS ZONING office use)
1520°1 F r-loaelks Trek, I N+^/ l�r�or �aKe MN 55372. / 51)
LEGAL DESCRIPTION(office use only)
LO L tha e—p-k N PID o 5- 1)3 6- OC)/-0
WN(ONS 1D( 11 S r o c) (Phone) , I2 2g 1--7°1(a 6
(Address) 15209 Fa r r�a rikS Trail 1 N W i�r t ur Lo.Ke M A) 5 5 3 7 2
APPLICANT
(Name) h o.-,f b I}ea F moo} a„`of it r Co vd<<f oh'^3 (Phone) 961- 5--777
(Address) 1 ( 5 (49'111'I I R°"( M Al 5 $y wq
(Address) (City) (Zip Code)
(Contact Person) 411,ti-o ti y (Phone) 95 2 l y�/�j- ?02_9
APPLICANT SIGNATURE 1 '441- 3-4 DATE 00 U -/6
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher I 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 $ I LI 1 ° Building Permit#
PLUMBING PERMIT FEE $ 149 5 0
STATE SURCHARGE $ $1.00
TOTAL PERMIT FEE $ 60 , 60
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid a to Receipt No.
Date VC 1 ( By
Building Official Date c) .:,26-
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372