HomeMy WebLinkAboutPLUMBING PERMIT 16-1249 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED (L(.*
--7 ! , be l'c�, A
ADDRESS
OWNER
CONTR. --
PHONE NO. `r�I
PERMIT NO.
%(p Z
0 PLUMBING RI ❑ EXIGRADIFILLING
❑ FOOT
A 0 MECH RI 0 COMPLAINT
O FRAMING ❑ WATER
O FOUNDATION 0 FIREPLACE RI
HOOKUP FINAL
0 SEWER HOOKUP 0 FIREPLACE❑ GAEPAIR TAT
❑ INSULATION 0 PLUMBING FINAL
❑ FINAL 0
❑ SITEMECH FINAL INSPECTIONkZ �I:
COMMENTS:
1i
I
ORK SATISFACTORY,PROCEED
CORRECT ACTION AND PROCEED
0 CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Owner/Contra CQa --------
Inspector:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURSIN ADVANCE.
FEI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH
INSNOTI
04 YRtO� Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT •
44141‘111s °
2:rid cA PERMIT NO.
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
/? (o e i ver Birch La- #/z) 655 7
LEGAL DESCRIPTION(office use only) •
LOT BLOCK ADDITION PID
OWNER j
(Name) �I(: LAJ1 v dO{c' (phone)959 -890- [9
(Address) -- (� rtA
APPLICANT
(Name) (one)
12850 Chestnut Blvd-.
(Address) Shaicvpee, MN 55379
(Address) 952-445-4803 (City) .(Zip Code)
(Contact P • ..l f I !I I (Phone)
APPLICANT SIGNATURE®f*Mb DATE
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 I%of job cost with a$49.50 minimum Residential,New One&Two-Family $149.50
Residential,Additions&Alterations $49.50
The Minnesota Statutes§326B.148 $ Building Permit#
"SURCHARGE"has been extended
The minimum surcharge for PLUMBING PERMIT FEE $ 411 a
rife
"fixed fee permit is STATE SURCHARGE $ L
! TOTAL PERMIT FEE $
This Application Becomes Your Building Permit When Approved Paid eceipt No.-1
Date 0 4toy .
Buntline Official Date
24 hour notice for an inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372