HomeMy WebLinkAboutPlumbing Permit 03-0164
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
S7r~ t.. (j,v ,""uocl S r
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
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
j-- 2 J
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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 ~O~A:L FOR REINSPECTION BEFORE COVERING
Inspector: ,IV r ,r;.,. ~YD) Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSliOTl
Date Rec'd
.....
CITY OF PRIOR LAKE PLUMBING PERMIT
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 5/03
APPLICANT I ( pO;...
(Name) n , . ~: W-I> ( kf.. (Phone) -.L:b 1- ~
(Address) .3Lo 10 roD D R.D ~tlt\lln M, N .'S-5' 7J ~
(Address) ~City) (Zip Code)
(Contact Person) L1.SC\. HDUDW~ (Phone) ~ClVVt.-L
/-'~PLICANT SIGNATURE ~ We\. f..{.JJ ru)tu,y DATE J (-7.<1~ 07 .
U APPLICANT PLEASE CO~PLETE 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
Sinks
Bar Sink
Water Closet (Toilet)
(Please tv1>e or orint and si2n at b~..~_)
ADDRESS
51 t::; 8 Cda r \l\Ltt>d ~+( -u1-
LEGAL DESCRLl' uON (office use only)
@ BLOCK
ADDITION
OWNER
(Name)
p(Lf>~_. Chf ,5-
~l ~ q Cu:1aA wood
S+I-flT
(Address)
Quantity
~~ ~:~ I PERMIT NO.03'" t/- ",f
(ellow Applicant c.tl'"1
ZONING (office use)
p L..{j)
:93 9 -oo~-c)
PID,~5""'J1j1~-o
(Phone) 9.52.- 44S- O'b37-
Type of Fixture
,
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
, Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
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 $ I q D . D 0
Building Permit #
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
,-L This Application Becomes Your Building Permit When Approved
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
$ .~CLSD
$ .50
$30.DO
J
Rece;;3'~~f
By r-
Paid llO ,..-'"
Dat~~7-d