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Monday, April 8, 2013 5���010
Current Resident S��ol��‘�� ��A��1v,��
15629 HIGHLAND AV � ������0
Prior Lake, Minnesota 55372 �ttiv,Cl0s �1�20�3
Re: Building Permit Number 11- 0204. We request your help
In review of the building permit files, it was discovered there is an open permit for
Water heater at the above address. Please call by Monday, April 22, 2013 to set
up an inspection. If there has been no contact from you by this date, the City will
deem the permit abandoned and invalid. (per State Building Code R105.3.2). This
permit abandonment will be recorded in the permanent public record for this
address.
Any new work relative to this type building permit will require a new permit along
with new permit fees.
Please call the Building Department at 952 - 447 -985() to schedule your inspection
date.
Thank you for your cooperation,
Sincerely,
Building and Inspections Department
City of Prior Lake
4 pRi Date Rec'd
e CITY OF PRIOR LAKE PLUMBING PERMIT
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[ PERMIT . cola City NO. I I , 0z04_,,
3. Yellow Applicaul
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
I.SZ7v I LL-ILA )4vc- J w __ - -
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER -- — — —
(Name) AI 61^p` \ 5 1 >_., (Phone)
(Address)
APPLICANT
( Name) 6 - vc u6 PV►'Liv1✓l .: ifIC (Phone) 7-s /--6 i Z—
(Address) 1 1L r 6 b 4 5 U c T� 10 ( t `�c.,S ka, "IA/ 6-5 l� ?
(Address) (City) (Zip Code)
(Contact Person) 1 S O P. l (Phone) �Sa - (-p / Z
APPLICANT SIGNATURE �� c ' DATE 3 I(
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough -ins
Dishwasher I 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
i — Vilater Closet (Toilet) 1 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
The Minnesota Statutes $ 32613.148 Est $ Building Permit #
"SURCI IARGE" has been changed for one 0 year effective PLUMBING PERMIT FEE $
July 1, 2010, until June 30, 2011. STATE SURCHARGE $ ° .5T1
The minimum surcharge for a "fixed fee" permit TOTAL PERMIT FEE $ .S L n 6-0 7 64'0 9
is .55, beginning July I, 2010
This Application Becomes Your Building Permit When Approved Paid5 S - D Receipt No. ( u /
_ Date 7' 4 ,, B • 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