HomeMy WebLinkAboutPlumbing Permit #13-1382 j_11,4 DATE TOECITY PRIOR LAKE SCHEDULED
INSPECTIONOF NOTICE
ADDRESS '
►i ! 1—�-
CONTR.
OWNER
PERMIT NO.
PHONE NO. ❑ F�GRADIFILLING
0 PLUMBING RI 0 COMPLAINT
❑ FOOTING 0 MECH RI ❑ FIREPLACE RI
❑ FOUNDATION 0 WATER HOOKUP 0
❑ INSULATIONAG 0 SEWER HOOKUP 0 FIREPLACEREPAIR FINALAL
❑ A0 PLUMBING FINAL 0
❑ SITEIEL 0 MECH FINAL
❑ INSPECTION
COMMENTS: 3
IR ,
.,c..�.. 4
r
WORK SATISFACTORY,PROCEED
CP CORRECT ON AND PROCEED
0 CORREC • ' CALL FOR REINSPECTION BEFORE COVERING
'� Owner/Contra
Inspector: ' '
CAL • 0 FOR THE NEXT INSPECTION 24 HOURS IN &SA�TI'!
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEAL
TH 11VSNOTI
0 rRI0� Date Recd
CITY OF PRIOR LAKE PLUMBING PERMIT -.
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File
Citi PERMIT NO.A3 ,2_
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(orrice use)
31fic �]yh weer- I V\Iw -Pr Le e , MN/
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PB)
OWNE
(Name) k l r (Phone)
(Address) 3li1 V/ 'rc>r LTJ s5372-
APPLICANT
(Name) 14-1"--0-1-z- �(�L.e �Yk'n� (Phone) I S Z--' 6 3
(Address) 111-1-B4 c-, exa, ? L i'4 e✓iI/t 11\i 5504-H
(Address) (City) (Zip Code)
(Contact Person) _j-cn. Mei)! (Phone) IS Z -- e1 3 '414'3
APPLICANT SIGNATURE /v � , 'A A ,,, DATE
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
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
The Minnesota Statutes FEE SCHEDULE
§326B.1.48 j joli cost with a$49.50 minimum Residential,New One&Two-Family $149.50
"SURCHARGE"has been extended • Residential,Additions&Alterations $49.50
• The minimuin surcharge for a
"fixed fee"permit is$5.00 Building Permit#
.PLUMBING PERMIT FEE $ 4 I. o
STATE SURCHARGE $ XXX 5.00
TOTAL PERMIT FEE $ \54/.. ,GO
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid s4. Receipt No.
Date /2"//7k3
Building Official Date
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372