HomeMy WebLinkAboutPLUMBING PERMIT 16-1384 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 12/20J1
ADDRESS a-572 w1tocaL'\_,
OWNER CONTR.
PHONE NO. PERMIT NO. /6 — / ct
❑ FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
❑ FOUNDATION 0 MECH RI ❑ 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 ❑ MECH FINAL ❑
COMMENTS: acrc.y_ .14eAtir,
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❑ WORK SATISFACTORY,PROCEED
SCORRECT ACTION AND PROCEED
❑ CORRECT 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!
INSNOTI
.()' [ \.P IO�� T Date Rec'd
EC/11\'
CITY OF-PRIOR LAKE PLUMBING PERMI a
F'
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t. slOC Fc,:,,, PERMIT IN- 6.--V.)4-7.
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3. Yellow Applicant
(Please type or print and sign at bottom) _
ADDRESS 1 ZONING(office use)
351"D. � 1\1o� _ I 6
LEGAL DESCRIPTION//�� (office use only)
LOT M CK' rADDrITION PID ZS /D6 •V, `40
OWNER
(Name) - O U )v)Ste( (Phone)
(Address) `j5j ) ', 0,) 1\ 1 ouu 6 C�C��
APPLICANT
(Name) l _C'_AA..)-)). �\ Com,SI � �� ‘ (Phone)
(Address) C 1 0tb b\\C--`�5.,`��L.00 Qm'� ti eD(Cf A (M 0 55Jgq
(Address)n (City) rJ /(Zip Code)
(Contact Person) T I w\ '!' b (Phone) -7(.0 -) - Lo (-7
APPLICANT SIGNATURE ems~- dam`' DATE I 1 /am)--,- -Dl L,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) 1 Other ('ra,,s p f.._ to(\,�- p asLe_,r'i(-'
c 0
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 $ 9 OD, CTE) Building Permit#
PLUMBING PERMIT FEE $ `49, 5
STATE SURCHARGE $ $1.00
TOTAL PERMIT FEE $ 53,50
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid ✓ , 5-0 Receipt No Zig?
Date ( 30 (19By
�
Building Official Date
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372