HomeMy WebLinkAboutPlumbing 03-0821
0" TE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
(P.2'i .01
IO:Tl!
ADDRESS .lb~?b lJJM~ M.
OWNER CONTR.
PHONE NO.
PERMIT NO.
"1- 8'21
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 EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
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COMMENTS:
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
ORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector
Owner/Contr:
- 50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
QUlREMENTS ARE FOR YOUR PERSONAL HEALTH &; SAFETY!
INSNOTI
I;
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
~.Z3.0J
~~;;~~ANT Ace v-.f d / tr?d ) I L{.Wl JIWJ
J '1.../
(Address) 7-"2 "/2)[) ~,V\e l1a,
(Addres.S)~
'TDV'V\ ) roC.
(Contact Person) , , \ ~!i
'PLICANTSIGNATURE ~~~ ~
/
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 sign at bottom)
ADDRESS
WoDd ~fjt L k
l~l2 0
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
(Address)
Quantity
I. Blue File PERMIT NO Zf
2 Gold City . 0 J ~ () ~ .
3. Yellow Applicant
rrllJ
ZONING (office use)
PID 25"" - ]1 l, .094' ()
(Phone)
(Phone) 05)) t.; & 9 -If tJtJ ()
7
LarriJi /(C57()YLf
(City) (Zip Code)
(Phone) {;r'l- 2 Lj- /- f 7 7(/
DATE (p/?_7/o~
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 # 03,... () $ 2- I
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
. (~ffice Use Only)
'his Application Becomes Your Building Permit When Approved
Building Official
Date
'3 ? JV
.50
4'(} .' uU
. paid4tJ .,vi)
DfJe. ~ ~ ,() >
. ReceirJ' ~(,1
By t-
O
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
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