HomeMy WebLinkAboutPLUMBING PERMIT 16-1382 CITY OF PRIOR LAKE
INSPECTION NOTICE DATE TIME
SCHEDULED l
ADDRESS 3(.0U I0• 6)
VL2- v
OWNER
CONTR.
PHONE NO.
PERMIT NO. J / ` �3 8 Z
❑ FOOTING ❑ PLUMBING RI .14e______:_❑ FOUNDATION ❑ EX/GRAD/FILLING
O FRAMING 0 MECH RI 0 COMPLAINT
❑ S N
0 WATER HOOKUP
0 SEWER HOOKUP 0 FIREPLACE I
• 'LUMBING FINAL ❑ FIREPLACE FINAL
❑ SI E INSP CTION •i] 0 GASLINE AIR TST
ECHFINAL 59-Wafer S -04.t-
COMMENTS: R'
II
/j
❑ RK SATISFACTORY,PROCEED
CORREC • TION AND PROCEED
❑ COR- CT •
R ,CALL FOR REINSPECTION BEFORE COVERING
Inspe or: AO
r Owner/Contra
CAL •7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY.
INSNOTI
;.:N7431411 PR1��\ Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
0
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NESO�
"e. �� 1. Blue File _
�r 2. Gold city PERMIT NO.
3. Yellow Applicant I
(Please type or print and sign at bottom)
ADDRE'SS ZONING(office use)
�Cw-e- (Th
Q.,y69._ P L)
LEGAL DESCRIPTION(office use onll�y)rr /41-4(/(2,/
LOT BLOCK / ADDITIOje e'//S Li �, 'u PID 2 5-576-407 `c)
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OWNER � ,�
(Name) � 4Y-1 U'\ CU c�(YN S (Phone)
(Address)
APPLICANT y.,,
(Name) � :\V I�U✓rYc (Phone)—4€0 S�. b ap
(Address) 532o\ Cort Q tile. 1�iC *tt_otia-aciff__ ' .---k-r-•52-
(Address) (City) (Zip Code)
(Contact Person) _• % A acct_ (Phone) 440)3-S �)
APPLICANT SIGNATURE "...40 ': ., •� - DATE (11 I SCJ
' i
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 1 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 $ BOO Building Permit#
PLUMBING PERMIT FEE $ li"t.
STATE SURCHARGE $ $1.00
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid 5v50 Receipt No. 10 I
t / V
Building Official Date Date 1 j . 2/0/
/b By -
24 hour notice for all inspections(952)447-9850 (�j/
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372