HomeMy WebLinkAboutPlumbing 03-0137
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
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~ 5~c- 1..0.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
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DATE TIME
c-/c
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o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ (rr../ L - 6? Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 5/03
File
I City
)w Applicant
PERMITNOO~ 1~1j7
(Please tvtle or print and sie:n atL. -"'--)
ADDRESS
~\ ShO{(. Ia.~
N D ttheCt5 4-
. ZONING (office use)
pLLfJ
LEGAL ~SCR1t' lION (office use only)
LOT tlBLOCK -.3 ADDITION bJ p~ tJZ^-
OWNER (l ·
(Name)~haW(a. : JSm IflJ.
(Address) lA:..Z..2! _~n f, N o (fhfas+
PIMS" ;).,15- ()L/3-(.)
(Phone) 1;/ 2- 3Ff 1..0- ~ to 2 7
(Contact Person)
Pi p-e,WD (K.~
DDDD RD
(Address)
LlS~ 1-\0 Ill) L1\J{)..\.t
t
, (Phone) j oC:; L 2J,PS--/3 4f\
F~CiCl n s51l3
-(City) (Zip Code)
(Phone) 1..-D'5 , - 3lth-l~ 4b
APPLICANT I' I P
(Name) "t , ·
(Address) 3( [J 10
.~ APPLICANT SIGNATURE
DATE
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher ! Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
. Laundry Tray (l 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 I % of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $ /q n ' tJ{)
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
~'1 ~tq)
.50
4D, D ()
(Office Use Only)
J. This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid I-( CJ. ..--'""
Date;k- 3 "'3
-.
ReC1!l~<>q /oq
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245