HomeMy WebLinkAboutPlumbing Permit 16-0071 DATE
TIME
CITY OF PRIOR LAKE SCHEDULED
INSPECTION NOTICE ' �� �
ADDRESS CONTR.
OWNER
PERMIT NO. ❑ F�GRppIFILL►►IG
PHONE NO. 0 COMPLikINT
FI
lio.---J---1----
❑ PLUMBING RI 0FIREPLACE RI
❑ FOOTIDG ❑ MECH RICE FINAL
CI WATER HOOKUP CI FIREPLACE❑❑ FOUNDATION
0 SEWER HOOKUP
❑ GASLINE AIR 7S7
CI INSULATION ❑ PLUMB►NG FINAL r,/� '
0 FINAL 0 MECH FINAL `� `
❑ SITE INSPECTION ��
COMMENTS:
J
ORK SATISFACTORY,PROCEED
❑ ORRECT ACTION AND
PROCEED COVERING
CORRECT WORK CALL FOR REINSPECTION BEFORE
pwner/Contr. VA--
Inspector:
NCE.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS 1 &SAFETY!UIREMENTSARE FOR YOUR PERSONAL HEALTH
CODE REQUIREMENTS
EQ INSNOfl
. - Date Rec'd
4 p�O•pCITY'OF PRIOR LAKE PLUMBING PERMIT. ' 1, . S, C
t..) 44011111rsclil. ' I. Goo Fi1e PERMIT NO.
- 2.Bole City
3.Yellow Applicant
ZONING(office ease i. or • ',t and,' , at bottom ,
ADDRESS r
511 o 0,0 --Lo-'-ix_i & - . T12-1 .
LEGAL DESCRIPTION(office use only) PID
LOT BLOCK ADDITION
C
OWNER / ck14-- (Phone)
(Address)
APPLICANT (Phone)
(Name) •�•�• lance onnections Inc.
1285 a sr . . : o (Zip Code)
(Address) (City)
(Address) Shakopee, MN 55379
952-44:i-4803
(Contact Person)
(Phone)
�f I
DATE =' �
— Z
3 `
APPLICANT SIGNATUREy ,1
APPLICANT PLEASE COMPLETE BELOW T- e of Future
•
uanti
e uanti T I�e of Fixture 111111111111111 Rou:l-ins
Bath Tub with or without shower IIIIIIIIIIIIII IIIIIIIIIIIIIIIII
Dishwasher 1 Water Softener
1.81
111111110111111 Floor Drain r Stand Po e ashin:Machine
-� Lavato :athroom Sink Sewa_e E'ector ' -
1111111111111 Laun' Tra 1 or 2 com•artment sink =- Backflow Assembl
1111111111111111 Shower Stall Backflow Assembl Test
111111111111111111 Sinks
Bar Sink Other
•
�_ Water Closet Toilet
FEE SCHEDULE $149.50Residential,Additions&Alterations Residential,New.One&Twa-Family
rations $49.50 ,
Industrial,Commercial&Multi-family 1%of job cost with a$49.50 minimum
Building Permit#
The Minnesota Statutes§326B.148 $
"SURCHARGE"has been extendedPLUMBING PERMIT FEE $_________#-T2---_ _31)
STATE S
The minimum surcharge for a /�
URCHARGE S __
"fixed fee"permit is 1rO 7v' /�
TOTAL PERMIT FEE $ v
i� r/�-2,6S `-f'
_ This Application Becomes Your Building Permit When Approved Paid . � Receipt No.,
Date By
OM
1. -/?. `�
sawn!Official Date 447-4245 4
24 hour notice for all inspections(952)447-9850,fax(952)
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372