HomeMy WebLinkAboutPlumbing Permit 16-1189 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED //it(t fl
ADDRESS ! `1 2-1.-i -
OWNER CONTR. /
PHONE NO. PERMIT NO. / (, -'it 87
❑ 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 ❑ GASLINE AIR TST
❑ SITE INSPECTION 0 MECH FINAL 0
COMMENTS: 1A')ak-_- )-14-r-
X::1WORKSATISFACTORY,PROCEED
O CORRECT ACTION AND PROCEED
❑ CORREC K,CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSlOTI
Date Rec'd
ti CITY OF PRIOR LAKE PLUMBING PERMIT
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Gold City PERMIT NO. /6 (igi
2.
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
S31Ue19tr- trail it_
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) L 1 n d Q ,11)60 (Phone) 6152.---100?-0g40 3
(Address)\y2--t5 ! 't.l ebt_r d +(L nAPPLICANTA
(Name) r ILA YA t v 40% ay)�Q (Phone) q e,—/-ko — K3q1
(Address) U Nun S 37Z
(Addr, s) (City) (Zip Code)
(Contact Person) ` C (Phone) '/5-2.— 1W/ 13fi
APPLICANT SIGNATURE , — _ DATE l f 2 Le(((p
4
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
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 $ 40a(/O Building Permit#
PLUMBING PERMIT FEE $
STATE SURCHARGE $ $1.00
TOTAL PERMIT FEE $ 57)
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid .6 y� Receipt o.
Date / G By
Building Official Date o° f 1 . •
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372