HomeMy WebLinkAboutPlumbing 03-0070
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED - / ;;~'k
t
SC;OO (~rr-c.NLVD"r/J
TIME
3~oo
ADDRESS
OWNER
PHONE NO.
CONTR.
,..... PERMIT NO. 03 - t210
o INSULA'f1VR
o FINAL
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
'~"'I-I FINAL
o SITE INSPECTION l..J n.__.
COMMENTS: Girt; .)(Pt~(e;
o FOOTING
o FOUNDATION
I]..!RAMING
---"I
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o t;?A.s: L.../ /t/2!E
I. ' 1
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~LLJS6'fi L..&
~WORK SATISFACTORY, PROCEED
~ ~RRECT ACTIO A D PROCEED
o CORRECT ORK, t L FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTl
.'
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File PERMIT NO
2 Gold City . /)-2 -()' A ~:)
3. Yellow Applicant 1/:7 U /'
(Please type or print and sign at bottom)
ADDRESS
5~OO
(loll-ON lJ.-bC)oJ-
ZONING (office use)
,25- t3'9&{X)lc2v
LEGAL DESCRi.l:'uON (office use only)
LOT
BLOCK
ADDITION
-
PID Cts
'-' .. I~ r:.K
(IT )- L.l-\,... \~ A",-~.1 &40"""".....)
(Phone)
(Address) 55":->0 Col't=~- L-l <.::>o._.",.J l....J
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a-w) ty:\ '(c;."'l,4r?lv."," U. ""'"1
(trtress) SC-:l5"'C> ,u-'~~c- u? ~ l D~
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~one)
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(.'COde)
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(G'aCiPerson) .~:'-'\ tt~V'~'
-- PP~NT SIGNATURE. /?.rt7~, , ~
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APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
I Sinks
I Bar Sink
I..,WAter closeD' J'oilet) ......
IltIA. {}tfJ4/ll~ I"u '0( tfl/tA/-'
'1 - r I U FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
,\(,_.~
(~)/-'-/)I-->)-0,6 '-j S--
;;Z;;'vATE' ~"" I '-1" -c.. 4-..
Quantity
Type of Fixture
)~J
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $ (;20DO,---
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
3Cf ~)O
.50
110.-
(Office Use Only)
Building Official
Date
. Paid LlO .
Dai-/5,3
~
. ReceiPll~ r; t.J a-- .
BY~
U
1"'his Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714