HomeMy WebLinkAboutPlumbing 03-0680
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
l,5l '-L (
SCHEDULED '1 - to -05
~_'..t'f +-et, ~>
OWNER
CONTR.
PHONE NO.
PERMIT NO.
<.
{,~CL
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
o GASLINE AIR TST
A LC\..W",-- <,;:~~
COMMENTS:
---
~RK SATISFACTORY, PROCEED
o CORRECT: frN AND PROCEED
o CORR T r~' CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ } OWner/Contr: {
CAL 44' .}g850 JR THE NEXT INSPECTION 14 HOURS IN ADVANCE.
CODE ~ENlS ARE FOR YOUR PERSONAL HEALTH" SAFETYl
INSNOTl
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
1. Blue File PERMIT NO 3
2. Gold City .' 0 _I (?/\
3. Vellow Applicant lO 0 U
(Please type or print and sil!;Il at bottom)
ADDRESS
/S 1~"7 t/U?6f's hts5
I ZONING (office use)
PI
LEGAL DESCRIPTION (office use only)
LOT L/ BLOCK ~ ADDITION Oj~. ~-r0
l' f)/) -
OWNER
(Name) \!.t-J.L.L Du~AV
PID~5-3qS-' OIR..{)
(Phone) 95.J -~33 -';;)~/5
(Address) JS/~/ d~",c:.~S ?#f$'. ~~/o/2 tCA~
APPLICANT
(Name) L.4LE ,.S/L)L. ~L-Bt f!- ~
(Address) /dJ'/67 2/,j.),(?/jp A't/.e:
(Address)
(Contact Person) C!A"'i'L ~d4e/s
APPLICANT SIGNATURE _.. ~ m~
I Quantity
I
I
I.
I
I
I
I
I
I
,
(Phon~) 9$./ - ?9$'" -/60 cr:::>
:..yqV4.6L
(City)
S53/J?
(Zip Code)
(Phone) 9..5:/- Rf'q- 76oc:>
DATE S~/o<
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity I Type of Fixture
Bath Tub with or without shower I Rough-ins
Dishwasher I . I Water Heater
I Floor Drain I I Water Softner
I Lavatory (Bathroom Sink) I I Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 compartment sink I I Sewage Ejector
I Shower Stall I I Backflow Assembly
I Sinks I I Backflow Assembly Test
I Bar Sink / I Lawn Sprinkler
I Water Closet (Toilet) I Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
Residential, New One & Two-Family $99.50
X-Residential, Additions & Alterations $39.50
Estimated Cost $
Building Penn it #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(39~ro
.50
~O.,.~
(Office Use Only)
....J This Application Becomes Your Building Permit When Approved
Building Official
Paid fPL;'O..- ---
Date b- 01..- 3
~e~~~~0~
BY~
l;
Date
24 hour notice for all inspections (952) 447..9850, fax (952) 447-4245
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