HomeMy WebLinkAboutPLUMBING PERMIT 16-1002 DATE TIME
CITY OF PRIOR LAKE SCHEDULED e L lc
INSPECTION NOTICE
1 4 53 2___ f Y10,�K, \+�o.�-t,
ADDRESS
OWNER CONTR. `r
PHONE NO.
PERMIT NO. 1Q0 •k � _
0 PLUMBING RI 0 EX/GRAD/FILLING
❑ FOOTING 0 MECH RI ❑ COMPLAINT
❑ FOUNDATION0 FIREPLACE RI
❑ FRAMING ❑ WATER HOOKUP
❑ INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
❑ FINAL
O PLUMBING FINAL 0 GASLINE AIR TST
❑ SITE INSPECTION
O MECH FINAL
f-1.,13COMMENTS:
a
ORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK,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!
INSNOTI
041?RIO) Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT 9 /_ /6
N
v
4,40125O
I.coin caey PERMIT NO. /'6, i Oci Z-
3.
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
f( (n aii4
7LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION ID
OWIR le r il,,,,d ihvim, 4,,,,j,,
4 :1,1/711rho
(Address)
APPLICANT b� �
Name) (Phone) �/ — dy f
94'Y
(Address) ‘2 fiz &ibez41C /14 11/4/ ilep mti c
(Address) (City) (Zip Code)
(Contact Person) A-OW --- (Phone)
APPLICANT SIGNATURE l/X- 2.1 DATE ag--1--/G
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 / 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 $ Building Permit#
PLUMBING PERMIT FEE $
STATE SURCHARGE $ /it
TOTAL PERMIT FEE $ j-V t 51)
(Office use Only) /2-0'7
This Application Becomes Your Building Permit When Approved Paid so_) Receipt No. '72$
Date F� � 6 By
Buildins Official Date 7 �...
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372