HomeMy WebLinkAboutPlumbing 03-0532
DATE TIME
SCHEQULED 'r t5i L 7/ tJ3
l t;l q ~ r:r- ~5 {do.-l:.S
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
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 1
o MECH FINAL /~
COMMENTS:
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0\0 'X!
s - 5;1'2-
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAL; ;~ST
~ -
~,. ~~_lt!:'.
~VV~"
.,
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
:.:::CT ~OR REINS:~:::':FORE COVERING
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
_._---""..._.._~--'_._._-"_._~-~'----,....._._..,_.~._....._,.,-_..---,-"_.~"_.
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
~. r. OJ
(Please type or orint and sign at bottom)
ADDRESS ZONING (office use)
/5/9f t::/E/.P'~/?-5 ,P;?.s-S
~: ~~ ~!~ I PERMIT NO'() ?-OS':>-'1 .
3. Yellow Applicant J:"'> c..-
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
I OWNER
(Name)
,4~ ,;t(~ L)~A~D
/S'/7'? /).e'//if',eS hJ2S
. .
. (Phone) 9~- 9/?"5/~7
(Address)
I APPLICANT ,
(Name) Z/lQ S/.DL ~t?6 ~ /-//6
(Address) /cJyt9 Z/,<}/C#A.I At/E
(Address)
. ~ft?L
d:/ ~~~
, . -...'-------------
(Phohe) 9SJ - c:?9c/- 76ao
S/lPA'6A. HA-J
,
(City)
(Contact Person)
(phone)
S.5"378
(Zip Code)
9S:J- ~V-76~o
DATE S'/S-/"3
APPLICANT SIGNATURE
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity. I Type of Fixture
Bath Tub with or without shower I Rough-ins
I Dishwasher I. I Water Heater
I Floor Drain I I Water Softner
I Lavatory (Bathroom Sink) I I Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 compartment sink I I Sewage Ejector
I Shower Stall I I Backflow Assembly
I Sinks I I Backflow Assembly Test
I Bar Sink I / )L I Lawn Sprinkler
I Water Closet (Toilet) I I 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
(Office Use Only)
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit # OJ' - 0 $"Jz.....
5'=
.37, ,
.50
c;I?J, .~
$
$
$
Estimated Cost $
.-J This Application Becomes Your Building Permit When Approved
Building Official
Date
Pai~
-rv. VV
Daty. r-. 0"5
~e~~iP~~ 2-] I
IBy ~
o
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245