HomeMy WebLinkAboutPlumbing 03-0556
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
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~'vV(
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED
C-/"f-0
(lW!cI/I.,..",.,1
CONTR.
PERMIT NO.
3-SSC
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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ft WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector: fV17 G/ l{ -([7 Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
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CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
5. 9. OJ
(Please type or print and sign at bottom)
ADDRESS
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~/77UC t//e;W
UK- J'b
Pt/O
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)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
(Address)
APPLICANT 1 P
(Name) ,-tD~ DJOA /DIt. fvC(
:;(1) ;>-/7--(1, ~ ,J
(Address)
(Contact Person) LL~""""'\ f1toJjYJ", / /7 /
- . l:'PLICANT SIGNATURE / ~N /L
(Address)
Quantity
L Blue File PERMIT NO 55b
2. Gold City .a1 :>-0
3_ Yellow Applicant U
ZONING (office use)
PIDZ5'" - jt;z. -O~- U
. (Phone)
(Phone)
1D <j:?J-J~J~
SS-7q]
(Zip Code)
/~/), dJ../ - '1 J-/7
DA;E e-J,~.<
- -
(Phone)
H fJ/' I<) 'rJ 5
(City)
Type of Fixture
"
x.
,
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 # .0 .f - 05.570
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
:3 9, S-O
.50
4-0.0(,)
(Office Use Only)
This Application Becomes Your Building Permit When Approved
~ ~.9.0J
Building Official Date
. Pai~t1. fA.)
D~ _ if. 0]
Receipt N~#~
By t!
()
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714