HomeMy WebLinkAboutBuilding 02-0788 (2)
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
Date Rec'd
'7 - / () -0 L
I. Green File I PERMIT NO
2. Yellow City . rJZ-07,f$
3 _ Gold Applicant
-30
ZONING (office use)
1)/1- /J uJ
LEGAL DESCRIPTION (office use only)
LOT ~K BLOCK
ADDITION
IE W!J..tJ$ SDLI rfj
PID
OWNER
(Name)
RI(E;AJIJE.tl (1)A)SNeLlC Vol() 2/1)G
Po f50X I 8)~ J...F!KbV/t.LE
(Address) (City)
(phone) ?~;~;:. 77tJ~
(Zip Code)
(Address)
APPLICANT
(Name) Fl/J A-L r;#/lLJF
(Address) 1e--1 Jh PJAR A~
(Address)
-rJjc..
S77(FJ=j
#)
(Phooe) 96J('-~-/~~
~5)f/9KD./'EE 553 7'
(City) (Zip Code)
(Contact Person)
(Phone)
DATE
APPLICANT SIGNATURE
APPLICANT PLEASE COMPLETE BELOW
Size of water service J inches.
Location of any couplings from structure ~ feet.
Type of sewer pipe. 0 ABC ~ PVC 0 Cast Iron
Estimated length of sewer line ~ feet.
Clean out (if required) located at -=- feet from structure.
FEE SCHEDULE
Residential sewer and water line connection $35.50 Industrial, Com'l & Multi-family
Sewer connection only $17.50 Water connection only
Estimated Cost $
Building Permit #
1% of job cost with a $39.50 minimum
$17.50
02 -v7e ~
.50
p{l-tO ~i
ttvO~
SEWER AND WATER PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
This Applifltj?YPbnes Your Building Permit When Approved
/(/1'1 VJ 7-[d --t V
Building Official Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS ~Q5 l:,b~ rr::-
NATURE OF WORK Al~J
USE OF BUILDING SFD I:
PERMIT NO. tJ 2 - 0 ~ DATE ISSUED '" - ~ V _ 02
CONTRACTOR 'b~_ - PHONE (;./2 - 7cf7-r"~fo
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
FOOTING
FOUNDATION (Prior to Backfill) \\
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIG ED
ROUGH - INS
f
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING if required)
FIREPLACE
GAS LINE AIR TEST lltn.. ~ F: P. fY~ o~
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I J
FINALS
J
!l)03
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS BEEN
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections have ~een approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
t:- / dJ c;;--::'
FOR ALL INSPECTIONS (952) 447-9850