HomeMy WebLinkAboutPlumbing 03-0580
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCAEDULED
t,-4
ADDRESS
J G 7 D 1A/1' 11111.. ~ {{.,..o ""'1
OWNER
CONTR.
PHONE NO.
PERMIT NO.
"? - ,f'oo
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
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
HL-6 !~~~
,
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1
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~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~R~>>LL FOR REINSPECTION BEFORE COVERING
Inspector: j! f/! (,,-L1-0'? Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
(Please type or print and sign at bottom)
ADDRESS
I. Blue File
2. Gold City
3. Yellow Applicant
PERMIT NO. a3-500
3Co 10 W'i\\a\0~eA-~ (rcU\ S~1:hLU~~t
ZONING (office use)
, 1(1 Sf)
(Contact Person)
'--~PPLICANTSIGNATURE(')./~~ ~-
~-: .
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), A4
LOT tf BLOCK ~ ADDITION 1l/4u<J (~
OWNER, \ \ \ 1"\ rt1Al I
(Name) N ICY\O \"{;lS: Uov-O "" '/
. (Address) 3~ '70 W~\low ~ T nUl . ~. W,
APPLICANT, \ \\ -;')l L
(Name) NOrD OW\ t" lJ.M\OI(\U
(Address) 2'10S C?J/J.4ft e.Jal Ave.:Sl?
(Address)
Quantity
PID d 5-1 ()q.. Of) 9-~')
(Phone) (liS2) "'t/-O .. ;y;qb
(Phone)
~Jt~;
(~'2.) 827 -403 3
5S'lOg
(Zip Code)
(Phone)
DATE
S-J,p /1"3
Type of Fixture
I
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 $ '-/00!!5!-
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
-"'"..........
This Application Becomes Your Building Permit When Approved
Building Official
Date
38.60
.50
1-1 0 .~O
Paid !jO/---
Date 6/1~--03
ReceiPfJ'tj 5 Lf/
By qv
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714