HomeMy WebLinkAboutPlumbing 03-0393
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
/ a. ~ fxat..A ~
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
It <6' c. ') I.LL1lI tJvv WMrI
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
,
/ I
I / /117/7'.
I/J~ .
0... TE TIME
{; "2('
~ - '3Q5
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
7"' /
rrl(
~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORREC~ /~/jALL FOR RE~~CTION BEFORE COVERING
Inspector: f IY / ~ - ~( Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
'11-.. T
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 5/03
Blue File PERMIT NO ~
Gold City . A3- -:;)/1
Yellow Applicant V v...,.
(Please type or print and sign at bottom)
ADDRESS
I {o r b3 ~ W.dhzu{,U(Jcd r1.vZJ
ZONING (office use)
If/
/'
LEGAL DESCRtt" uON (office use only) d
LOT 6BLOCK /ADDITION V~ ~~3 PID~5-3.;L~-()O(;-()
_. fT
'l<Uthel UvSon ~.~~G,.l/3~)
(AddresS)}(pff}'3 f//j)lotJ/JloPt( L'Vt,/c 56 .j:f;{)(' LAK~ I17N t)~t)-3-7d....
APPLICANT ,~:/ L 01 /,1 1f/2';n r;j)-'J '1""\ I' - 435-r
(Name) 1'\ tA{;nv L,.ft/fJ.vn (Phoner/~ 'doL lP ' . 7
(Address) ---L/La?? W/l!(Wwood &/c. S[ 'Pyibt' {If k ,L)!53'},}
(Address) (City) (Zip Code)
I (j ~h. - '1 (phone) 1'9 ,,:)Jtr. Lf 35>{>
',.,114M (J ~1j~" /-1-/3/03
V
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)
Quantity
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
v
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 $
~q,S-D
; I"C .50
'-(0,-
L/ tf()t;3
Receipt ~~' rB
By (j&
I
(Office Use Only)
"-'his Application Becomes Your Building Permit When Approved
Building Official
Date
paid1J LIO. ---
I DatL;_ '3 -- 3
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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