HomeMy WebLinkAboutPlumbing Permit 16-0141 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED VV1
Ci
ADDRESS G 51'r` D 0j.
OWNER CONTR.
PHONE NO. PERMIT NO.
❑ 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
❑ FINAL 0 PLUMBING FINAL ❑ GASI,INE IRT T
❑ SITE INSPECTION 0 MECH FINAL )3I fJ
COMMENTS:
0_.(cne_jtk
WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ COR• CT •RK,CALL FOR REINSPECTION BEFORE COVERING
Inspect.r Owner/Contra
—_CA J 50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
116NOTI
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMITgO • • 2 s zG
I.Blue File
2 cold cap PERMIT NO./&,, /4_j
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
C -' I -1 -1 Oak, R,i ( g -e CriSE
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER Rd 8 0Ffe
b
(Name) _ (Phone) q s z— 4 e 4-o(Q I ' (0
(Address) CS 1 1 `1 Gct_k. MC (Cr- S E.. (Drd r l__ di-e I
APPLICANT 1 �
(Name) pi ii s Oh— V- vvIR, p�.Vhnblln9� (Phone) '� ).- �,S—GO(Qd
(Address) 1 3191 7-o i- t u( [ (--t\ 1\l_4) Do 1-o h Ian Ni . --S 3 2:7
(As) (City) (Zip Code)
/ G, �,r^r'o � 1 -- 4(Contact Person) P3-'*i (Phone)
APPLICANT SIGNATUREq"-- stsiz9ft,
c DATE Z Z I I O
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantitya of F7iature _
Bath Tub with or without shower Rough-ins
Dishwasher I Water Heater — CA-e._c'-r)° t,
Floor Drain Water Softener
Lavatory(Bathroom Sink) Stand Pipe(Washing Machine) -
Laundry Tray(1 or 2 compartment sink , Sewage Ejector
Shower StallBackflow 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 4 Q `S."-C2
minimum surcharge for a PLUMBING PERMIT FEE $
"fixed fee"permit is$4.00 STE RH .: —do-
TOTALATPERMIT FEE $ ,c-o i .S—C)
This Application Becomes Your Building Permit When Approved Paid (.57).. 5) Receipt Receipt No. 9
Bu IIna Official Date
Date2_. zee.%& By CSL
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372