HomeMy WebLinkAboutPLUMBING PERMIT 16-1285 D TE TIME
CITY PRIOR LAKE
INSPECTIONOF NOTICE SCHEDULED
ADDRESS `"15& -f'Vv'.° -' "``S
I
OWNER CONTR.
Flo _ 2
PHONE NO. PERMIT NO. J(,-- /.5
❑ FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
0 MECH RI
❑ FOUNDATION0 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 0
COMMENTS: ()at- s -L_ . , d' oa A{-1-t--
WORK SATISFACTORY,PROCEED
ORRECT A TION AND PROCEED
0 CORRE W c ALL FOR REINSPECTION BEFORE COVERING
Inspector il Owner/Contr:
Or
CAL, 7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTI
Date Recd
04 vRr°4c. CITY OF PRIOR LAKE PLUMBING PERMIT
N
v
,.'Zea Fi,ecity PERMIT NO./(P_ f X85 --
cor
3.Yellow Applicant
ease j. or • and u, at bottom
ZONING(office use)
ADDRESS `.. ` -✓� 6 553 -) d-
LEGAL
53 -) d`LEGAL DESCRIPTION(office use only)
PID
LOT BLOCK ADDITION -7 Q-
OWNER
(Name) L/VIIG n,,� (Phone) ` -7 �f�
✓ J O Y V 1 ' '
(Address)
APPLICANT Appliance Connections Inc (Phone)
(Name) 12850 C►)estnut Blvd
(Address) • (Zip Code)
(Address) ' 952-445-4803 (City)
(Contact Person •.l1 t �-•� /' (Phone)
orpr
1011APPLICANT SIGNATURE AP/ Air� l,,/0 DATE C1-
APPLICANT PLEASE COMPLETE BELOW T e of Fixture
Quan T A t e of Fixture II uanti --
Raul�-ins
Bath Tub with-or without shower ��
Dishwasher Water Softener
Floor Drain � '
athroom Sink Iy_ Stand Pi•e ashin: Machine
Lavato --- --
Laune Tra 1 or 2 corn,artment sink �— Backflow Sewa:e E ector
ctor l
Asse
Shower Stall Backflow Assembl Test
Bar Lawn S+rinkler
Sink
Water Closet oilet Other
FEE SCHEDULE
Residential,New One&Two-Family $149.50
Industrial,Commercial&Multifamily 1%of job cost with a$49.50 minimum Residential,Additions&Alterations $49.50
Building Permit#
The Minnesota Statutes§326B.148 $
"SURCHARGE"has been extended PLUMBING PERMIT FEE $
The minimum surcharge for a STATE SURCHARGE $ L
"fixed fee"permit is :�o TOTAL PERMIT FEE $—
Building Permit When Approved Paid 1,3t c----0� 3(J
This Application Becomes Your (§ B t •
Date
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