HomeMy WebLinkAboutPlumbing Permit 16-1195 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED /444.,
2
ADDRESS 30(st I Ek , Q
OWNER CONTR. /
PHONE NO. PERMIT NO. / G ^ / f
❑ 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 0 GASLINE AIR TST
❑ SITE INSPECTION 0 MECH FINAL ❑
COMMENTS: bt) --1- r
1
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WORK SATISFACTORY,PROCEED
❑ CORRECT ;CTION AND PROCEED 1❑ CORR -'•RK,CALL FOR REINSPECTION BEFORE COVERING
Inspecto A Owner/Contr:
r
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOT'
O4 II RIO Date Rev'd
CITY OF PRIOR LAKE PLUMBING PERMIT
W I
2.� aty c3 PERMIT NO.s
/(Q 1 I 7
3.Yom. Anima
(Please type or print and sign at bottom)
ADDRESS • ZONING(office use)
3(34° ( 44lig: lief- RI
LEGAL DESCRIPTION(office use only) .
LOT BLOCK ADDITION PID
OWNER .� �� I�1Ga-.1" f5 b
" ) - 1/- "7/21
(Address) • 5tfrir..e2.___________-__
APPLICANT _ . .
(Name) Appliance Connections Inc. (Phone)
(Address) 12850 Chet MN 55379
9A5-4843 % fi (city) (Zip Code)
(Contact Person) U CA,VYA`('i V,,i ,...kff.-- 4,---
(Phone)
I 11/((o :,
APPLICANT SIGNATURE'd . ,& DATE
-
APPLICANT PLEASE COMPLETE BELOW
Quantity - Type of Fixture Qaandiy , Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher ' 1 Water Heater
–
Floor Drain Water Softener
`
Lavatory(Bathroom Sink) - . Stand Pipe(Washing Machine)
Laundry Tray(1 or 2 compartment sink Sewage Ejector
Shower StallBackflow Assembly
Sinks Backflow Assembly Test __
Bar Sink Lawn Sprinkler
Water Closet(Toilet) I Other
SCHEDULE
Industrial,Cowl&Mei-family 1%of job cost with . New One&Two-Family $149.50
.. .- i.- Additions&Aketations $49.50
The Minnesota Statutes§326B.148 $-.— I ng'Per #
"SURCHARGE"has been extended PLUMING FERIvIIT PEE $ ill,
The minimum surcharge for !
"fixed fee"permit is$ STATE SURCHARGE ,S t
, ti v0 TOTAL PERMIT FEE $ �.01, 5e)
This Application Becomes Your Bonding Peru When Approved . Paid Sz Receipt No. rI 1 Z O
BY /
> dba Official Date Date 1 U. l �,l(v _1
24 hoar notice for a8 inspections(952)447.90,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372