HomeMy WebLinkAboutPLUMBING PERMIT 16-1119 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS 2SCHEDULED f 2112/1
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673 �CbCG�t. l r
OWNER CONTR. /
PHONE NO. PERMIT NO. (L C (
❑ 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 ,gt_t.cic.,Ecr L-(4 r
COMMENTS:
COGS _4-1 L.")
✓ -WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRE 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!
1NSNOTI
�1 PRIO
�� �� Date Rec'd
., l CITY OF PRIOR LAKE PLUMBING PERMIT
jA'NES0
2:ned FA PERMIT NO.
3. Yellow A licant /e,. //
(Please type or print and sign at bottom) P°
ADDRESS
'}� ZONING(office use)
2;151 / � NYV.
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER) C/� I�y-�,� ILo�s f(Y�
(Name) l (Phone) I 2"&)�1 Y.'14Q-1 7
(Address) 2 / 12) P WWcvt N vv
APPLIC rr
(Name) V-41/VN - 1V1A)h r W v UN1 1 ` (Phone)
(Address) 06IM Ii1 -a` •
WI/1k )
(Address)
(City) (Zip Code)
(Contact Person) Y---071\ (Phone) 0 f„ 2 -C� 2 C2-1
/I I0 I "/ �p0^^ '1
APPLICANT SIGNATURE (A)6 -4 DATE "I' 26 'I t0
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture _ Quantity Type of Fixture
Bath Tub with or without shower Rou.h-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
FIndustrial,Commercial&Multi-family 1%of job cost with$4SCHEDULEE
$49.50 minimum New One&Two-Family $149.50
Residential,Additions&Alterations $49.50
Estimated Cost $ Building Permit#
PLUMBING PERMIT FEE $ 441-
STATE
_STATE SURCHARGE $ $1.00
TOTAL PERMIT FEE $ )t)-
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid 5-6 „5-0 Rece. t Noi f('(i
DateVi‘ By
Building Official Date
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372