HomeMy WebLinkAboutPlumbing Permit #16-0051 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 7-,) IZ
ADDRESS � I 5-0.4
OWNER CONTR.
PHONE NO. PERMIT NO. \ (e-, —S
❑ FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
❑ FOUNDATION 0 MECH RI 0 COMPLAINT
❑ FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
❑ INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
❑ FINAL 0 PLUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION ❑ MECH FINAL ,
COMMENTS:
CORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector. CX2; Owner/Contr:
CALL 44T-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTI
ijitra,P o
Date Reed
CITY OF PRIOR LAKE PLUMBING PERMIT
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. I. Blue File
2. Gold City PERMIT NO/& , C'/
3. Yellow Applicant .J
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
56/06) J56 c / cam'
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
(O1VaWNE) A/O
IZ L rn��
4571d/rn (Phone) /JrQ -3 n- 7t2 90
(Address) Se(PO JS() ..... 1--. �s12-'
•
APPLICANT //
(Name) C!'IGi1 p/Oil //11AIkI(P (Phone) 6S/- 365- tin)
Address 36 70 if a ,�
(Address) add � � 'y.4 ii SSI on(Address) d(City) (Zip Code)
(Contact Person) / i PPA _ 'Ca, • 4,j/-36,S'_ /39V
,� ; (Phone)
APPLICANT SIGNATURE - ' '� / 1 / 1/15. // 6.
DATE
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher / 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
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&Alterations $49.50
ost $ Building Permit#
The Minnesota Statutes ti 326B.148
"SURCHARGE"has been changed for one et:
year effective PLUMBING PERMIT FEE $ E �Q
July 1,2010,until June 30,2011. STATE SURCHARGE $ .50
The minimum surcharge for a"feed fee"permit TOTAL PERMIT FEE $ r 627w 5)
is 35,beginning July 1,2010
This Application Becomes Your Building Permit When Approved Paid y e eipt No. 34
Date d/ y
Building Official Date I� I Y
24 hour notice for all inspections(952)447-9350,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372