HomeMy WebLinkAboutPlumbing 03-0573
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
ADDRESS
-'Y/7~
SCHEDULED "/- ),O~
/.fJJ/MKA I~ ~lj[ (I t-
CONTR.
PERMIT NO. )- ~ 7"f
OWNER
PHONE 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
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
~GA6L1NE ~IR ~S\
ft to"'.... ~ I
COMMENTS:
/
~RK SATISFACTORY, PROCEED
o CORRECT ACTI . AND rROCEED
o . ~ALL ~OR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CA,I_'-
HE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE
ENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
~, -~. -------_._-~_.-._.~_._"
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
~. ~~ ~~~ I PERMIT NO. .lr a,. S ~ ~
J. Yellow Applicant ( .J.:..J '..{
(Please type or print and sign at bottom)
ADDRESS D.
1'1\15 l-\~~ owd
Gi- .
ZONING (office use)
reI
LEGAL DESCRIPTION (office use only)
LOT ~ BLOCK ~ ADDITION,map Ie
(Contact Person)
11/1/5
AV\nt.t\e Fa.ukv! CV\vl~ rYh 1 \LCLhy
~
tv IAJ\-L 5 ~(ktl
L,ILf ?1@ A\,.e6&1
(Address)
~~S
PI~o"~l/a-O~5-6
OWNER
(Name)
(Address)
(Phone)
Qoa-'d'03-IDltD
(Address)
(Phone) l." ~ . ~D 1- 6d1d)
\1LOr..hi ~ 66.1.f:j)
(City) (Zip Code)
APPLICANT
(Name)
(Phone)
~
~-..A.PPLICANT SIGNATURE
DATE
Quantity
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)
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 $
16(fL
Building Permit #
Building Official
Date
$ "6'1 . eo
$ . .50
$ LID .00
paidfil Lf /J I ~
Date 3/IIl-{f3
Rece~lI53i1
By , Ck) .
u
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
~.l. This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245