HomeMy WebLinkAboutPLUMBING PERMIT 16-0883 DATE TIME
CITY OF PRIORNOTICE LAKE /i/SCHEDULED S ----
ADDRESS s r t7 0
OWNER 'ONTR.
PHONE NO.
PERMIT NO.
0 PLUMBING RI 0 EX/GRAD/FILLING
❑ FOOTING 0 MECH RI 0 COMPLAINT
❑ FOUNDATION0 FIREPLACE RI
❑ FRAMING 0 WATER HOOKUP
0 SEWER HOOKUP 0 FIREPLACE FINAL
❑ INSULATION
❑ SITE
FINAL 0 PLUMBING FINAL 0 GASLINE AIR TST
❑ SINSPECTION 0 MECH FINAL
COMMENTS: `
11.
WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contra
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOT7
R10 ::Date Recd
$ :CITY OF PRIOR LAKE PLUMBING PERMIT
v
tPi: .
� c aka a PERMIT NO,. �i,��i ,
3.Yaw A OAK /� . V V�
(Pleasetree or and at bottom) . . >-.
ADDRESS' ,
1 C, c/o rias Plixe, -, e,,.
ZONING(oraoe ase)
LEGAL DBsCRIPTION(omaa e011Y)
LOT BLOCK ADDITION pm _
OWNER / r .
(Name) All . A IA t ) qs .-07- a& Y
APPLICANT _ •
(Name) Apeliwiceiconnthetirts IAC. - (Phone)
(Addiess) -Chlittat9 t,,
( :. •. s (City) (rap Code)
(Contact P. ,i IY) 1 ''G. (Phone)
APPLICANT SIGNATURE .'�aa . . _ _ / DATE l //t1' -.',
APPLICANT PLEASE COMPLETE BELOW
• Bath Tub with?or wart � Type
endure
Dishwasher . 1 T Water Heater ,
Moor Drain _ \_ Water Softener •
' . Lavatory(Bathroom Sink) - Strad Pipe(VVashinglMeese)
Laundry Tray Shower Stall (1 or 2 sink AssemblyBackflow . .
Sinks Backflow Assembly Test
Bar Sink _ Lawn Sprinkler ---
- Water Closet(Toilet) Other
FEE SCHEDULE
Industrial,Commercial& 1%ofob coat with a$4930=Winn= Rei,New One&Two-FaoaRy 5149.50
- Rami,Additions&Akeuttions 54930
The.IvMinnesota Statutes§3268.148 $ &MingPennit.# —
"SURCHARGE"has been extended ,
The minimum surcharge for a _ PLUMBING PERMIT Ih_ $
"fixed fee" rm1 is • STATE $ L
pe $5"88" . TOTAL PER IT FEE $
l,no ,
This AppReadsn Beeentes Yaw Building Pe When Approved . Paid No 6 emcf
teildies om 1 .ire /6 BY!,
24'beer notice for all inspeetions(952)447- t (OM 447-4246
4646 Dakota Street sR,Prior Lake,Minnesota 55572