HomeMy WebLinkAboutPlumbing 07-1188
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
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OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
SCHEDULED
I (Q /1.-",
51
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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DATE TIME
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o EXlGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
o WORK SATISFACTORY, PROCEED
rf CORRECT ACTION AND PRO~D
o CORRECT WORK. CALL F~INSPECTION BEFORE COVERING
Inspector:
,
Owner/Contr:
~ALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
Il.?' 7. 0 1
(Please type or print and sign at bottom)
ADDRESS . ZONING (office use) .
~'zoo (G;.O~ 5-t. -:p( 10V Lake
I Blue File PERMIT NO. 07- /18 a
2. Gold City . U
3 Yellow Applicant
LEGAL DESCRlr lION (office use only)
LOT
BLOCK
ADDITION
PID 25.0?&. bO 7.0
&~e~R.:p a." k wooo.. A pt~ .
(Address) ::Po, Box 5507 '12-
(Phone) q J52 - 440 - 4-y.:rf
M l MN .'
i ~V1e-apo ',~ ,',54-5B
APPLICANT~ ,'j) 'I') { 'L
(Name) ...J./ ra..i "" 1'""'ro "'t""" U&.-vIV II-'tq
----../
(Address) 8~\.5 loll -tt, St. W.
(Address)
(Phone) qs 2 Lf-&q (p q qq
L-alLevi lle 5:5044-
(City) (Zip Code)
(Contact Person) --JeNl0 (Phone) q52- fC,q ~qC( 9
APPLICANT SIGNATURE ~ ~ DATE 12.ZI.07
~P~ICANT ~ASE COMPLETE BELOW
Quantity Type of Fixture Quantity I Type of Fixture
Bath Tub with or without shower I Rough-ins
Dishwasher I Water Heater
I Floor Drain I Water Softner
I Lavatory (Bathroom Sink) I Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 compartment sink I Sewage Ejector
I Shower Stall I Backflow Assembly
I Sinks I Backflow Assembly Test
I Bar Sink I Lawn Sprinkler
I Water Closet (Toilet) I Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $ 15 1 S _ 00
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.0 cr50
.50
LJO.OO
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid 40, C/()
Date; .....1 () 1
2- . t ,
I
Receipt Yl.5S1/ /
By [_
o
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714