HomeMy WebLinkAboutPLUMBING PERMIT 16-919 DATE TIME
CITY PRIOR LA32? ` ----
INSPECTION NOTICEKE
SCHEDULED
I
20 0. 1ADDRESS 1
CONTR. q
OWNER .1_6_��j
PHONE NO.
PERMIT NO.
0 PLUMBING RI ❑ EXIGRADIFILLING
p FOOTING 0 MECH RI 0 COMPLAINT
p FOUNDATION 0 FIREPLACE RI
p FRAMING ❑ WATER HOOKUP 0 FIREPLACE FINAL
p INSULATION 0 SEWER HOOKUP 0 GASLI E AIR TST
❑ FINAL 0 PLUMBING FINAL
❑ SITE INSPECTION
0 MECH FINAL
COMMENTS:
652 U '
lik
WORK SA SFACTORY,PROCEED
❑ CORRE' T 1 N AND PROCEED
0 CORR. ,i' ,CALL FOR REINSPECTION BEFORE COVERING
MrOwner/Contra
Inspecto ,
CALL -'850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTI
Date Rec'd
O4VRIO
CITY OF PRIOR LAKE PLUMBING PERMIT
grC) g•
r
4ziontso'� 2.:a c:f.), I PERMIT NO. ,./6,` i / 9
3.Yellow Applicant
(Please type or print and sign at bottom) ZONING(office use)
ADDRESS
097?O Cc r'' ? jUio)
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID ,
OWNER //n ie / t (Phone) 5 a., 4 6®
(Name) Le,vi
I (Address) ':.
Set ,/ -
APPLICANT
(Name) ApP( �� Connections Inc(phone)
12850 Chestnut Blvd.
(Address) shakope(Address) 5-4803MN 379 - (Zip Code)
•
( _) 952 (Cita')
(Contact Person) VCZ = e . ..1 (Phone) 1
SIGNATURE �L�AT����'►! M DATE C, ` ./ ,
APPLICANT IG
APPLICANT PLEASE COMPLETE BELOW of Fixture
Quantity - Type of Fixture Quantity
-Bath Tub with or without shower Rau. t-ins
Dishwasher Water Heater
Floor Drain 0 Water Softener
Stand Pipe(WachinQ Machine)
Lavatory(Bathroom Sink) Sewage Ejector
Laundry Tray(1 or 2 compartment sink Backflow Assembly
Shower Stall
Sinks Backflow Assembly Test
Bar Sink Lawn S rinkler
Water Closet(Toilet) Other
FEE SCIIEDT,7LE _
Industrial,Commercial&Multi-family 1%of job cost with a$49.50 minimum Residen. Residentiaal,Addial,New tions&Alteratne& ions$ $49.50
The Minnesota Statutes§326B.148 $ Building F)ermtt# -
"SURCHARGE"has been extended PERMIT FEE $
41qThe minimum surcharge for a" -STATE SURCHA.ReE $ _ , 0 I tai,
"fixed fee"permit is • TOTAL PERMIT FEE $ ' 5 )
D' 5
Permit When Approved Paid R ipt No.J (00 6
This Application Becomes Your Building PP I�j�.: 5�
Date / `11 . 1 ti ,
Building Official Date
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372