HomeMy WebLinkAboutPlumbing 03-0163
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
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OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULA liON
o FINAL
o SITE INSPECTION
COMMENTS:
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
1;[1 7
3- / r; "J
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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jJ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT;~ CA~ FOR REINSPECTION BEFORE COVERING
Inspector: 0 r- 5 -l1r ~ner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
l/VSNOn
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 5/03
(Please tv1le or print and SilDl at b. ...._)
ADDRESS
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LEGAL DESCRu- nON (ollke.", omy) 1.
LOT ,dawCK t( ADDmON flJ.M1 cL j2f 4l7-
Blue File
Gold City
Yellow Applicant
( ~li)
I PERMIT NO.03- I" '3
ZONING (office use)
pun
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(Phone)46Z- 2~3-lll5
OWNER --n... L_- ...-r-::
(Name) VI,tTy l~ I bYMet1
(Address) (.sd-ntL as ttbovt.)
CULLIGAN 'vVATCn CONDITIONI~'~
6030 CULLIGAN WAY
_.~ ...- - ~KA r 1N S534r (Phone)
1\1/11'<11'11:: I 01 , v ...,
(952) 933-7200
APPLICANT
(Name)
(Address)
(Address)
(Contact Person)
~'/Ju.LY
~PPLICANT SIGNATURE
(City)
(Phone)
DATE
(Zip Code)
/- /7-tJ.3
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 (lor 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 $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $ ~D /"
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
,1 This Application Becomes Your Building Permit When Approved
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
3QSD
.50
4-0.00
Paid 1ft;. ---
Date~_1_0
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--'
I Receipt NJ;f3/ J~
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