HomeMy WebLinkAboutPLUMBING PERMIT 16-946 DATE TIME
CITY OF PRIOR LAKE SCHEDULED __:
INSPECTION NOTICE y l
S,V__RIL*
ADDRESS
OWNER
CONTR.
(1_,2__, '
PERMIT NO:
PHONE NO. ❑. �GIZgpIFILLING
❑ PLUMBING RI 0 COMPLAINT
❑ FOOTING ❑ MECH RI 0 FIREPLACE CE
I
❑ FOUNDATION 0 WATER HOOKUP 0 FREPLACE RINAL.
❑ FRAMING 0 SEWER HOOKUP FIREPLACE
AIR TST
❑ INSULATION 0 PLUMBING FINAL
❑ FINAL MECH FINAL
❑`"'SITE INSPECTION 016 Z
COMMENTS: -
('WORK SATISFACTORY,PROCEED
O CORRECT ACTION AND PROCEED
O CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
pwner/Contr.
Inspector. � 24 HOURS 1N ADVANCE.
CALL 447=9850 FOR THE NEXT INSPECTION HEALTH�SAFETY!
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEAL
ration
�� R104, Date Rec'd
'tj l CITY OF PRIOR LAKE PLUMBING PERMIT
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kAtESD
City Fde .PERMIT NO./
2.Gold
3.Yellow Apphcant
(Please type or pint and sign at bottom)
ADDRESSZONING(office use)
1 Colo 00 1 Cr r ' (+. 5E, 'Poo,-
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER ,, /, �
(Name) V V/I/ L_O U-.,r (Phone)
��yy £53�L
(Address) /tote" 00 �iG,CT��4- (11-- ���_ T11t�V' i
(NameC WatizjTi_e z4
(Phone) 52 -453 - / 3
(Address) I 7'+5'7" bootIoeL. p 55-044
(Address) (City) (Zip 'Coo/de)
(Contact Person) '`--12II -h >✓ N`c-f/J /:v (Phone) 'lSZ "C1 3"—Li'�'T 3
APPLICANT SIGNATURE 4:_! , _ —_: DATE _______84.57/1/‘
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 $ //'9 Sa
STATE SURCHARGE $ $1.00
TOTAL PERMIT FEE $ \,5d, Sa
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid ' ✓S1) WI• No.
Date r By
Building Official Date
�I
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372