HomeMy WebLinkAboutPLUMBING PERMIT 16-651 D TE TIME
CITY OF PRIOR LAKE
t INSPECTION NOTICE SCHEDULED ( Z
ADDRESS `-15-& --{`VV- .V'-k'- '1.t)11
OWNER CONTR.
(Co — 1-211 —
1 PHONE NO. PERMIT NO. lb— I r7 (
❑ FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
❑ FOUNDATION 0 MECH RI 0 COMPLAINT
IW" ❑ 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: Wat,- Sv c , d` 14--)a .- r
Cte�. 1-,10 ti.l ( /
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WORK SATISFACTORY,PROCEED
ORRECT A TION AND PROCEED
❑ CORRE Wc ALL FOR REINSPECTION BEFORE COVERING
Inspector I Owner/Contra
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CAL, •7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
&SNOTI
4 PR/04, Date Rec'd
r~ 9 CITY OF PRIOR LAKE PLUMBING PERMIT
A'NEs°�
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Gold ApCit p OCu, ii IS�Sr
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3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
I-15g Pumrn/k3 eird -Tr/
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
O((NWNER 610 5 O K l,Jl (Phone) /`5,? ./ST✓q, ila 2_
(Address) e--6-eq trmi9 Mrd Th-1.
APPLICANT
(Name) t'1��eY / rckC/m Co one) 7 7 2 5S
(Address) g75:5/ /s� �/ f� � � CSC ce,e-7-/6v c'("0,57
(Address) (City) (Zip Code)
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(Contact Person) it,' wL (Phone) '(9 1L�- �g(1/ 'z.r7 c 0
APPLICANT SIGNATURE A J 1/(47a6-4-8---/C1 DATE w /( 2
AP°WANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher I 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
Estimated Cost $ Building Permit
#
PLUMBING PERMIT FEE $
STATE SURCHARGE $ $1.00
TOTAL PERMIT FEE $
(Office Use Only) 19/
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This Application Becomes Your Building Permit When Approved Paid Rec pt
Dat LJN 2 2 2016 By ,/
Buildine Official Date
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372