HomeMy WebLinkAboutPLUMBING PERMIT 16-0826 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED
ADDRESS T,.. 1 Cl, .
OWNER CONTR.
PHONE NO. PERMIT NO. \ •
❑ FOOTING ❑ PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
❑ FINAL ❑ PLUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION ❑ MECH FINAL 9
COMMENTS:
O IC
WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
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Inspector: Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTI
A
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
t.
W „
`.r'° `g` I PERMIT NO.
3.Yeaow App5a�
(Please type or print and sign at )
ADDRESS ZONING(office use)
41 (7CI Oc2°4 cki- 7)i' 5 553 -7
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER. �)_ / - I � � �(o'
(Name) l CA i�O i--
V ) (Phone) 9 n/�
(Address) ;�O YomAPPLIC __
(Name)A . -P 1101/1C-C_ C014Pt OChoKS' (Phone) 95? 44 5 4867
51i k
(Address) g . . C r/ i Vt /_ * '-,
55
(Address) (City) (Zip Code)
(Contact Person) • Cr ' _ 0 L f 5/-1 e (Phone)
--
APPLICANT SIGNATURE I , .. .(.�-.C) til. 4.i, 0
_ ._ DATE a' )
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower _Rough-ins
Dishwasher 0 Water Heater
Floor Drain _Water Softener
Lavatory(Bathroom Sink) Stand Pipe(Washing Machine)
Laundry Tray(I or 2 comment 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
The.Minnesota Statutes§326B.148 $ Building Permit#
"SURCHARGE"has been extended PLUMBING PERMIT FEE $ �
The minimum surcharge for a STATE SURCHARGE $ I OD
"fixed fee"permit is o TOTAL PERMIT FEE $ 50v SZ)
This Application Becomes Your Building Permit When Approved . Paid. �,, 1'o Receipt No. lY 3 cy
Dam -27-1?
Buddies!Oil Date (r� S
24 hoar notice for an inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372