HomeMy WebLinkAboutPLUMBING PERMIT 16-1012 pATE TIME
CITY OF PRIOR LAKE SCHEDULEDCilll ----
INSPECTION NOTICE
ADDRESS t' Li- tV C- '
OWNER CONTR. j �(
PHONE NO. 4 PERMIT NO. ( 1 Z` —
0 PLUMBING RI ❑ EX/GRAD/FILLING
O FOOTING 0 MECH RI 0 COMPLAINT
❑ FRAMING ❑ WATER HOOKUP
❑ FOUNDATION0 FIREPLACE RI
❑ FIREPLACE FINAL
O INSULATION 0 SEWER HOOKUP 0 PLA AIR TAT
❑ FINAL 0 PLUMBING FINAL
❑ SITE INSPECTION
0 MECH FINAL /4.2...3 ,-'t..
COMMENTS:
r
.i; F J
1, YORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
tea.. Owner/Contra
Inspector:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTI
• • •�° PRIp� Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
M'I'N E s°�� t.
2.BGold lue FCity I �ile PERMIT NO. / V/Z,
3. Yellow Applicant
(Please type or print and sign at bottom) ZONING(office use)
ADDRESS
got-f 4(o Tir4erc t /Pf. S�
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION y/4 t-Qt"+.v..+"" PID
OWNER (Phone) 7 $6 Z Z
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(Name) Crno�rl a $GJ� C
(Address) a 7 T,)+t Ie v#4 t•• +" • J
AP(NaPLImeCANTc ,L Un PlU 1 tb1 fl (Phone) (5t �J[Q✓ 1 J-1V) j���� � �J
(Address) ail b DO .�. 12.64. 44100 mn(Zip Code)
55'�2
(Address) (C ) C 1
J l 4 I eplet........... (Phone) t✓6 -31OS- IV�D
(Contact Person)
APPLICANT SIGNATURE -� . ��f �C�%dieer' DATE q/24/1 V
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher 1 Water Heater
Floor DrainWater 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 SinkLawn 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 $ 9 O• tro Building Permit#
PLUMBING PERMIT FEE $ q `• s )
STATE SURCHARGE $ $1.00
TOTAL PERMIT FEE $ 5"0 •Sw
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid D S Receipt No6 0 7(
Date Date (L�j / /_ BY
Building Official "( 1 l�
24 hour notice for all inspections(952)447-9850
4646`D'akota°Street S E.,'Prior Lake,Minnesota 55372