HomeMy WebLinkAboutPlumbing Permit 16-1080 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 1_014
ADDRESS I LID Lk e.34tiy
OWNER CONTR. / p
PHONE NO. PERMIT NO. l —/Oc6
❑ 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 0 GASLINE AIR TST
❑ SITE INSPECTION 1 0 MECH FINAL 0
COMMENTS: Wak51c
CI65P.
AWORK SATISFACTORY,PROCEED
❑ CORRECT •N AND PROCEED
❑ CORR a K,CALL FOR REINSPECTION BEFORE COVERING
Inspecto 1 Owner/Contr:
CA L ••'-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
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p PRI% Date Recd
CITY OF PRIOR LAKE PLUMBING PERMIT
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I.Gold Bluec`ile-�, PERMITNO., ////� �i /}
(Pleaser!pe or peat aaa sign at bottom) 3.Yellow Applicant
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ADDRESS
14°4 a I ue (d l r JU
55 ZONING(officeuse)
LEGAL DESCRIPTION(office Use only)
LOT BLOCK ADDITION PID
(Nam) CJ►1 BrotAJ 1/1
(Phone) 0I & 3 600
(Address) — S Q _
APPLICANT
(Name) Appliance Connection gge)
• 12850 Chestnut l►d.
(Address) aknpfa , MN 553 9
(Address. 952-445-4803 ( ') (Zip Code)
(tet Person) Lin UP CO '1 _ (Phone)
APPLICANT SIGNATURE �.. ,l t, DATE ,
, -7\
APPLICANT PLEASE COMPLETE BELOW
Quantity . • Type of Fixture Quantity Type of Fixture
Bath Tub with or without showerRough-ins
Dishwasher Water Heater
Floor Drain Vi 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
Cil&1 a-ram,ty 1%of fob cost with a$49.50 min Resldsptial,New One&two--rte+ $149.50
- Residential,Additions&Alterations $4930
The Minnesota Statutes§32613.148 $ Building'Permit#)
",,SURCHARGE"has been extended
The minimum surcharge for PLUMBING PERMIT FEE _ $ 4g
"fixed fee"Permit is STATETAL SURCHARGEPERmiTFEE $ 110.t..50-1
; L '
'8$' TO $
Thik A�a Becomes Your Building Perms When Approved Paid S--U Receipt No.
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BaSdioa Metal t 61� '
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24"hoar aodee for an bons(952)447-9856,fax(952)4474245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372