HomeMy WebLinkAboutPlumbing 03-0265
DATE TIME
CITY OF PRIOR LAKE 5-~'1-o~
INSPECTION NOTICE SCHEDULED t l'.3C)
ADDRESS I LI i <f8 S(j~ { -JVr
OWNER CONTR.
PHONE NO. PERMIT NO. T- 2t,s
o FOOTING 0 PLUMBING RI 0 EXIGRADIFILLlNG
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULA nON 0 SEWER HOOKUP 0 FIREPLACE FINAL
o FINAL 0 PLUMBING FINAL -&~A~: ~R TP~
o SITE INSPECTION 0 MECH FINAL ^ W ~.f~
COMM~TS: .
\. ~u;~t3~_ ~C~S'~ 1^I~c;c,
VI"' 0 t1JJ - () - J
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o WORK SATISFACTORY, PROCEED
XCORRECT ACTION AND PROCEED
o CORREgzo CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ _ Owner/Contr:
CALL. W ~ FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
COD~UlREMENTS ARE FOR YOUR PERSONAL HEALTH &; SAFETY!
INSNOn
,-
CITY OF PRIOR LAKE PLUMBING PERMIT
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 5/03
~~~R, tP (i ~ h \n .rrtfft
(Address) \\..l C1 Lt~ ~trY\f\\l} rl~ f\W
~;~~T -& 0~\),~ \Y\lleLI D'1l\tYtl~one)\ \'0' ~O -/<UG/ .
(Address) :=Si ~ 0~~ ~ f\ G\-c HSL\ t1ttd~ CD \ SLlDIC,
(Address) (City) (Zip Code)
(Contact Person) ~.lfY""'\. . (Phone)
/-"PLICANTSIGNATURE_\~ ,~.~ DATE
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
Sinks
Bar Sink
Water Closet (Toilet)
(Please type or print and siltIl at bottom)
ADDRESS
\ 4 Q L jl) ,~) \f\m14 (\i~ f\\ 1 ')
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
Quantity
\
Date Rec'd
. Blue File PERMIT NO t0f
,Gold City . J\~ "'1 .
Yellow Applicant V::; Ci"'"
ZONING (office use)
PUD
(Phone)
PIr8EJ "3fJ7"Ofo ~ -0
J
I ~CSI-ddl-61ld.
01Ul03
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 $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
'f'his Application Becomes Your Building Permit When Approved
Building Official
Date
~lsO
1 ; .50
'-t Il \ DD
Paid rf./
~4'(J.--
. Date 3-/1-3
Receipt Nt/V 004
By .{(5!/
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714