HomeMy WebLinkAboutPLUMBING PERMIT 16-868 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED (3 y(lc,
ADDRESS ?j J 1 . 5 1---(4 4-- c::)! -
OWNER CONTR.
PHONE NO. PERMIT NO. IL _ o e)
❑ 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 0 MECH FINAL ..t...,..,}..,
COMMENTS:
5 dot-104-v-,
CSk-1-&-di
4WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT 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!
wSNOTI
Date Rec'd
1OPRI fit'
\`,� CITY OF PRIOR LAKE PLUMBING PERMIT
t, 1._._. \'
Lrj . ,,SQ'
LANES I
I. nl,t�• l'i, I PERMIT NO. /' _6 6 e
2 Gold City
3. Ycllow Applicant
(Please type or print and sign at bottom)
ZONING(office use)
ADDRESS
3 546 f' i\riv4, 5v3
LEGAL DESCRIPTION(office use only)
PID
LOT BLOCK ADDITION
OWNER (Phone)
(Name)
(Address)
(Name) DIbrL AVM 1 k_9 (Phone) `1113. 47). 21L7
(Name) nn,, � _
(Address) 1���5 M 111,xL. r� , Phiww-Aii{'l, ! r^n 55LN'J
(Address)
l (City) (Zip Code)
(Contact Person) 5a11.A.l) (Phone) .11i • 253.418 r
APPLICANT SIGNATURE / MIA,v > ' ;'n DATE 1. Z'C( 1-04O
APPLICANT PLEASE COMPLETE BELOW
.. Quantity Type of Fixture Quantity
T •e 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 1 Lawn Sprinkler P
Water Closet(Toilet) Other
FEE SCHEDULE
Industrial,Commercial&Multi-family 1%of job cost with a$49.50 minimum Residential,New One
$149.50
Res dential,Additions&Alterations ons $950
Estimated Cost $ Building Permit#
PLUMBING PERMIT FEE $ .4 Cll.%
STATE SURCHARGE $ $1.00
TOTAL PERMIT FEE $ '50
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid 6 so Receipt No.JlO ``II'�
Ay
Date Qi By ,�-
—
Building Official Date V
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.L.,Prior Lake,Minnesota 55372