HomeMy WebLinkAboutPlumbing Permit #14-99 QATE TIME
ClTY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED �_�_'T_7
ADDRESS —/ �
✓ ,�� .�..- r �
OWNER CONTR.
PHONE NO. PERMIT NO. _���_
❑ FOOTING 0 PLUMBING RI ❑ EX/GRAD/FILLtNG
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE Rt
� INSULATION O SEWER HOOKUP ❑ FIREPLACE FINAL
❑ FINAL ❑ PLtlMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION O MECH FINAL ❑
COMMENTS:
^
`�� ORK SATISFACTORY, PROCEED
t/O CORRECT ACTION AND PROCEED
❑ CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: _ - -! OwnedContr,
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS !N ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY.�
lNSNOTl
o � pg��� 7� � Date Rec'd
� CITY OF PRIOR LAKE PLUMBING PERMIT �'�,!�
v �
��5°'� ,. 8�,� File PERMIT NO
2. Cotd Ciry • /�
3. Yeliow Applicant { �
lease or ' t and s' at bottom
ADDRESS ZONING �o�re ��
( �- � � Z �,�V C`;} -� Ir S �. O� �� �
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
owr�R �-� �-� `N d r n-e�' �� — 7 — c�'r��F-- 4 a 3 Z
(��e) (Phone)
(Address) ( `� 4 1 Z w d—�k--21rS �� � ('�'� O�� �� � S�3 �
(Name) ANT� C�vV� � Ol� — T( �- � ( V M IJ I �'1 ' (phone) � ( Z—��`S� �� � � d
(Address) ' �J � � � �G ►r1 C�� t,� � � �--�`1 1 v � � � �'1 � Y V �S � 2/ 7
(Address) (City) (Zip Code)
(Conta.ct Person) � �—� � (Phone) l� j Z ` � / � � � �'
APPLICANT SIGNATURE ����� DATE �� r� I � T
APPLICANT PLEASE COMPLETE BELOW
uanti T e of Fixture uanti T e of Fia�ture
Bath Tub with or without shower Rou h-ins
Dishwasher Water Heater
Floor Drain Water Softener
Lavato athroom Sink Stand Pi e Washin 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
Residenrial, Additions & Alterations $49.50
The Minnesota Statutes § 326B.148 t$ Building Permit #
" SURCHARGE " has been extended pLUMBING PERMIT FEE $ '�' ����
until june 30, 2013, STATE SURCHARGE $ S� .-r3'0
The minimum surcharge for a TOTAL PERMIT FEE $ � 4 S �
"fixed fee" permit is $5.00 ` �—
This Application Becomes Your Building Permit Whea Approved Paid �� L� Receipt No. t'��i �
7
suildine Ofticiat Dste Date . Z� ��J By
�t
24 hour notice for all jnspections (952) 447-9850, tax (952) 447-4245
4646 Dakota Street 5.E., Prior Lake, Minnesota 55372
_ - :�::. _ ,..
.- :. - _.
,:
��