HomeMy WebLinkAboutPLUMBING PERMIT 16-1053 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 2._\2LApo
- c —
ADDRESS
OWNER CONTR.
PHONE NO. PERMIT NO.
0 PLUMBING RI 0 EX/GRAD!FILLING
❑ FOUNINGDATION 0 MECH RI 0 COMPLAINT
❑ FRAMING 0 WATER HOOKUP
❑ FRA0 FIREPLACE RI
INSULATION
0 SEWER HOOKUP 0 FIREPLACE FINAL
❑ p
❑ FINAL 0 PLUMBING FINAL GASLINE AIR TST
p SITE INSPECTION 0 MECH FINAL
COMMENTS:
O WORK SATISFACTORY,PROCEED
p CORRECT ACTION AND PROCEED
O CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contra
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
,NSNOTI
Date Rec'd
OQ YRtp4t
CITY OF PRIOR LAKE PLUMBING PERMIT
+/AW•>
E S 'S7. 1.Blue File
2. Gold cit
y PERMIT NO. / & / G_`3 ri
3.Yellow Applicant
lease E or and si. at bottom ZONING(office use)
ADDRESS
1it4 a4 Ph:to oa-i St . S6
LEGAL DESCRIPTION(office use only)
PID
LOT BLOCK ADDITION
OWNER
(Name) 0 a1Yt, 0 t skAd (Phone) a 5 a - 441)—r13°6
(Address) 4 4ay' Pii1. d!rid.o..0 cd., )
APPLICANT (Phone) 715-386 8667
(Name) Croix Crystal Water Treatment
(Address) 3440 Yoerg Dr., Hudson, WI 54016 (City) (Zip Code)
(Address)
(Phone)
(Contact Person) Jim v ,
APPLICANT SIGNATURE
, L. C � L2) DATE
APPLICANT PLEASE COMPLETE BELOW T , of Fixture
T t e of Fixture Quantit
I uanti -_
Bath Tub with or without shower Rout -ins
Heater
Dishwasher 1 Water Softener
Floor Drain Stand Pipe(Washing Machine)
Lavatory(Bathroom Sink) Sewa:e E'ector
Laun s Tra 1 or 2 corn,artment sink Backflow Assembly
Shower Stall Backflow Assembl Test
Sinks Lawn Sprinkler
Bar Sink Other
Water Closet(Toilet)
FEE SCHEDULE
Industrial,Commercial&Multi-family 1%of job cost with a$49.50 minimum Residential,New One& -Family $149.50
Residential,Additions&Alterations $49.50
Estimated Cost $ Building Permit#
PLUMBING PERMIT FEE $ 9 Of
$1.00
STATE SURCHARGE $ r 5 p
TOTAL PERMIT FEE $ 50
(Office Use Only) t No. j %!
This Application Becomes Your Building Permit When Approved 61) � Recei+ (
Paid ' t1 q 03
Date (1/ t y (9 BY
,11.1111111111111111
Building Official Date
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372