HomeMy WebLinkAboutPLUMBING PERMIT 16-523 T TIME
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CITY OF PRIOR LAKESCHEDULED
INSPECTION NOTICE
ADDRESS
CONTR.
OWNER /(< • �Z3
PERMIT NO.
PHONE NO. ❑ GRpDIFILLING
0 PLUMBING RI 0 COMPLAINT
FOUNDATION• FOOTING 0 MECH RI 0 COMPLAIN
❑ A 0 WATER HOOKUP 0 RIINAL
❑ FRAMING 0 SEWER HOOKUP ❑ FIREPLACEREPAIR NAL
❑ INSULATIONA0 PLUMBING FINAL
❑ SITEEL 0 MECH FINAL
❑ INSPECTION \ 'W7--
COMMENTS:
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ikWORK SATISFACTORY,PROCEED
p CORRECT ACTION AND PROCEED
❑ CORRECT W K,CALL FOR REINSPECTION BEFORE COVERING
Owner/Contr.Inspector.
L 447_9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.NY!
CAL SAFETY!REQUIREMENTS ARE FOR YOUR PERSONAL
INSNOT1
PR/04,
� Date Recd
�� CITY OF PRIOR LAKE PLUMBING PERMIT ` /
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Blue File
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z.Yew Cpy PERMIT NOll„'®��7
3.Yellow Applicant (((/ i
(Please type or print and sign at bottom)
ADDRESS __ ZONING(office use)
1Q'3Ct - �� v k1/41.0 SL Pvb
LEGAL DESCRIPTION(office use only) 1124,2-6199'C—/
LOT BLOCK ADDITION a/ /13/ 77m �cr7 , PIDZ-3-74/1)--119C
(Name)OWNEEli V L O`\ ))y.V 1 (PhoneM V 4k14---15()(49
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(Address) WQ:64,C1 — 1.t VtdOa1f' ...,N1&4 iQY`LLOS 6, Y to I UAL
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APPLICt
(Name) L \ it_. , AA.. X L . n. `�� r 1... (Phone))q`L-VAO-4tit
(Address)`4'O :Z9'.- l♦ ! RAILAIM
1 00 b I •
(Address) (City) (Zip Code) _
(Contact Person) 4.. &(&(.)1/4.___ (Phone) CA-‘04....A....-
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APPLICANT SIGNATU' _ _ \ ►.% !_VS\1, P ATE
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APPLICAN 'LEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher 1 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
O Residential,Additions&Alterations $49.50
Estimated Cost $ ' . v
6!W Building Permit#
PLUMBING PERMIT FEE $ 9Q 0
STATE SURCHARGE $ $1.00
TOTAL PERMIT FEE $ ,v"50
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid b---0 Receipt No. 5-4„
Date By S
Building Official Date 5: z11.4.
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372