HomeMy WebLinkAboutPlumbing Permit 14-1038 CITY OF PRIOR LAKE DATE
INSPECTION NOTICE TIME
SCHEDULED ���-----
ADDRESS 1 S Co 8 o '
OWNER ..�.
CONTR.
PHONE NO.
PERMIT NO.
❑ FOOTING ❑ PLUMBING RI
O FOUNDATION ❑ EX/GRAD/FILLING
❑ FRAMING ❑ MECH RI ❑ COMPLAINT
❑ INSULATION
0 WATER HOOKUP
O FINAL ❑ SEWER HOOKUP 0❑ FIREPLACE RI
fl PLUMBING FINAL FIREPLACE FINAL •
❑ SITE INSPECTION 0 GASLINE AIR TST
MECH FINAL
COMMENTS:
V J` ❑
u ct.)
_ 1
Sit 1413, •�! _
I
WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
0 CORRE WO•K ALL FOR REINSPECTION BEFORE COVERING
Inspector: Air
VW- Owner/Conte
CALL 770 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY/
INSNOTI
II
4 PRtO� Date Reed
CITY OF PRIOR LAKE PLUMBING PERMIT -.
ti
'dl ej f.81ue' Fife
2.Gold City PERMIT NO. 104 e
3.Yellow Applicant
(Please type nr print and sign at bottom)
ADDRESS ZONING(office use)
I 6 .1S0 — 144 541 lafi.A.Ai ,
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
-
(WNE
Na R �Ul'Yl •- (4.21--„, .41,,,-it (phone)/, , -�J oo -4 9 7T
(Address) ISb O 4-1464 tri41., , N\,u3 p„...;..„, )G.-tt_t_ , 01 u5's�- 2
_, 7
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APPLICANT
(Name) P i 0- i4/ 44.4....e.,
44.4....e.,44.4....e., (Phone) 6 I.) 9,(i 40 ZD o q 2 _
(Address) 7 2-2 cp ^ �' vc�t , (� -7v P-4'f ..Q I) 2 ._
(Address) it ) (Zip Code)
(Contact Person) (Phone) 4P I Ds 1 7(o Ob _
APPLICANT SIGNATURE ,. 1 , .,..41/141..:i 4r_ -' ' -)DATE
S i
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
I Bath Tub with or without shower Rough-ins
I Dishwasher Water Heater
Floor Drain Water Softener
I 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 Water Closet(Toilet) Other
FEE The Minnesota Statutes-§326B.1.48 Nob'cost with a$49.50 minimum
Residential,New One&Two-Family $149.50
"SURCHARGE"has been extended' - . ' Residential,Additions&Alterations $49.50
• The llliuinllnn surcharge for a ' .
"fixed fee"permit is$5.00 Building Permit#
-PLUMBING PERMIT FEE $ 4 7 ..�J
STATE SURCHARGE $ X)63 5.00
TOTAL PERMIT FEE $ cif.50
(Officel)seOnly) 1-Zj." p.
This Appiicat i B •me. . Building Permi- he Approved Paid
'-)(--/ Receipt No. �1 Z ¢
2-61
7/ Date I By nl\` 1,6„._
,
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Buildia¢Offfcial Dat. `111- 4'� _ 1l' W
24 hour notice for all Inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.R.,Prior Lake,Minnesota 55372