HomeMy WebLinkAboutPLUMBING PERMIT 16-1245 DATE TINE
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED I II
ADDRESS 387 S
OWNER CONTR. /
PHONE NO. PERMIT NO. /G -- / Z`/r
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❑ FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
❑ FOUNDATION ❑ 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 r
COMMENTS:
(% oma—
f] WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORREC WORK,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!
INSNOTI
�l PR. �{ Date Reed
,7, • CITY OF PRIOR LAKE PLUMBING PERMIT
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2. Gold City PERMIT NO.
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3. Yellow Applicant _
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
3375 peri r ss No, Fri a!"I,G.j.s. AtN, S 37. 7,...
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER /
(Name) krty Fath e6-� (Phone) U?li -67e ^81F4
(Address) 3$7 5- 2-C14.1 T4.S‹ Ai/Aft rr or L.J.,,, /", s>1? -2-
APPCryt on P1 bi (Phone) IQSt-X7t 5- J V
(NamIIeANT`j
h
) Dodd � I1C
(Address) _a510 Dodd o. 44ioo mn ,5JC 127
(Address) (C' ) (ZipCode)
(Contact Person) 1 I 1 C101e (Phone) UV r, toS' 1 �V
APPLICANT SIGNATURE d ti‘4
� )/ DATE /610//46
41.
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 $ 5 6 O. 0 0 Building Permit#
PLUMBING PERMIT FEE $ Li R. co
STATE SURCHARGE $ _ $1.00
TOTAL PERMIT FEE $ 5 C) . co
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid 5D Ref eipt No. 1.z_2,Z
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Building Official Date Date 10 ' Z� (,W B
24 hour notice for all inspections(952)447-9850
"4646 Dakota:Street S.E.;-Prior'"Lake,-Minnesota 55372