HomeMy WebLinkAboutPlumbing Permit 16-1031 CITY OF PRIOR LAKE DATE TIME
SCHEDULED G� 7 INSPECTION NOTICE
ADDRESS
CONTR.
OWNER
PERMIT NO.
PHONE NO.
❑ FOOTING 0 PLUMBING RI ❑ EX/GRApIFiLLiNG
COMPLAINT
0 MECH RI 0 0 FIREPLACE RALf
❑ FOUNDATION 0 WATER HOOKUP 0 FIREPLACEFINAL
❑ FRAMING 0 SEWER HOOKUP 0 REINE AIR NAL
❑ INSULATION 0 PLUMBING FINAL 0
I
❑ FINAL
❑ SITE INSPECTION 0 MECH FINAL
COMMENTS:
3 . :_yam- _ ,Uk
82
)(WORK SATISFACTORY,PROCEED
In`CORRECTON AND PROCEED
0 CORRECip' CALL FOR REINSPECTION BEFORE COVERING
' OwnerlContr:
Inspector: . ,
CAL '• 0 FOR THE NEXT INSPECTION 24 HOURS IN & N !
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH
INSNOTI
4i VRI% :Date Recd
ity
0
CITY OF PRIOR LAKE PLUMBING PERMIT
i:rid /to /
3.Yellow Amami
(Pleasetype or print and sign at bottom)
ADDRESS ZONING(oho use)
341(0 6 4ten Waler 7h /1W 553-2g,-
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
(N J 0_( � W(3S � (Phone) 959-44 1-', ..g,-3S-
(Address)
- d( ) 3a
•
(Name) ApplienCr.Connectins Inc.(Phone)
TZB-becoriestnut8Jvd. .
(Address) r . MN 5009
(Address) 1)044 (City) (AP Code)
(Contact Person) r IA ° 1 /J/_' ,g,_ )
APPLICANT SIGNATURE [int A..... Ii Li 1..11 DATE
---91NCIi114--
APPLICANT PLEASE COMPLETE BELOW
Quantity - Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower 40 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 StallBack low Assembly
•
Si _ Backtlow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet('Toilet) Other
FEE SCHEDULE
Industrial,Cil&Multi-fimnTy 1%of job cost with a$4930 miaiam Residsptial,New One&Two-Family $149.50
- • Residential,Additions&Alterations $4930
The Minnesota Statutes§326B.148 $ BuildiniPermit#
"SURCHARGE"has been extended The minimum surcharge forPLUMBING PERMIT FEEL),
a`
STATE SURCHARGE .$ t L 4110
"fixed fee"permit is$5;OO' , TOTAL PERMIT FEE $
This Application Becomes Your Building Permit When.Approved . Paid
c b st ltNo.()tris---
maw Offal I date Die CI, ` f 1
24hoer notice for all inspections(952)447 fax.(952)447-4245 V
4646 Dakota Street S•E.,Prior Lake,Minnesota 553'72