HomeMy WebLinkAboutPlumbing Permit 10-0937 DATE TIME
CITY OF PRtOR LAKE
INSPECTION NOTIC� SCHEDULED l�
ADdRESS laT�(�'� Ct��A,C ('eQ5'C,
OWNER CONTR. _ ��� 3 (� �1/lvlti��
PHONE NO. PERMtT NO. �6 —� 37 NZ.�° fr�
❑ FOOTING 0 PLUMBING RI ❑ FJUGRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
O FRAMfNG 0 WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
O FINAL ❑ PLUMBING FINAL ❑ GASLINE AIR TST
� SITE INSPECTION ❑ MECH FINAL ❑
COMMENTS: - J,�}�� �'=F-�--
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WORK SATISFACTORY, PROCEED �� _�� _�2�
❑ CORRECT ACTION AND PROCEED
❑ CORRE , CALL FOR REINSPECTION BEFORE COVERING
Inspector. Owner/Contr.
CALL 44 OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY!
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� p itjp Date Rec'd
� �� CITY OF PRIOR LAKE PLUMBING PERMIT
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2 Gold C�ty PEllit'lIT ��. / ��
3 Yellow AppUcant �
lease or ' t and si at bottom
ADDRESS ZONING �ot��,��
Co�o's l�.(���s S-r Sr.
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) �. «� �'�c,.: �+�'�' (Phone)
(Address)
APPLICANT
�� Lc��w l� � ��..� � �., � ��.� � �� 5 (Phone) '7 c�3 zg � r �k 9 7 �
(Address) g 71�( �..`oo1�c��s% �-• /�(�tzc-�`��v S-S3loZ
(Address) (City) (Zip Code)
(Contact Person) � v.1-�-� � � �Z� � � (Phone)
APPLICANT SIGNATURE DATE / o
APPLICANT PLEASE COMPLETE BELOW
Quanti T e of Figture Quanti T e of Fizture
Ba�h Tub with or without shower Rou h-ins
Dishwasher Water Heater
Floor Drain Water Softener
Lavato Bathroom Sink Stand Pi e ashin Machine
Laun Tra 1 or 2 com artment sink Sewa e E'ector
Shower Stall Backflow Assembl
Sinks Backflow Assembl Test
Bar Sink Lawn S rinkler
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 & Alterarions $49.50
Estimated Cost $ Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $
�ot�c� u� on�y�
This Application Becomes Your Building Permit When Approved Paid � Re pt No. /��!�
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Date�� ` /! l � � .
Buildine 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