HomeMy WebLinkAboutPLMBG 08-0621
DATE TIME
CITY OF PRIOR LAKE 8/26/ ce
INSPECTION NOTICE SCHEDULED
ADDRESS L(cr~ ~~~~
OWNER CONTR.
PHONE NO. PERMIT NO. B - ee,g..\
o FOOTING o PLUMBING RI o EX/GRAD/FILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL o GASLlNE AIR ~
o SITE INSPECTION o MECH FINAL ? ~}- ~
COMMENTS:
A\
t \ OSe... -- ~
(\
-\-: \ ~
....eJWORK SATISFACTORY, PROCEED
o CORRE<;.J)ACTION AND PROCEED
WORK, CAll FOR REINSPECTION BEFORE COVERING
Inspectol":'L n Owner/Contr:
CA'1lL ~~850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
IN$NOTl
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
f /~; fiy
I. Blue File PERMIT NO
2. Gold City . i) D, {I /{ Z I
3. Yellow Applicant l' ( t,
(Please type or print and siJ(n at bottom)
ADDRESS ZONING (office use)
Lf970 ,A1(J,r-~;J1~ Sr,AJc
(Contact Person) ~ (Phone)
APPLICANT SIGNATURE~--?1 ,.::f:~~
. I
APPLICANT PLEASE COMPL~TE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (I or 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
L t' P1 riA- !i,
Ei~.AYlJ
(Address)
APPLICANT
(Name)
(Address)
(Address)
Quantity
)(
,
PID
(Phone)
QS2- ~LfS-5~J,
, . - J
(Phone)
(City)
(Zip Code)
DATE
JY //5)tJ?'
Type of Fixture
Rough-ins
Water Heater
Water Softener
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 $49.50 minimum Residential, New One & Two-Family $149.50
Residential, Additions & Alterations $49.50
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
4-9. 50
.50
$'b. (JD
/"
This Application Becomes Your Building Permit When Approved Paid :.)( (".' () Ret/No. 5Z- s (;. (.,
Date, I .c/ Bvt'
Buildinl! Official Date t:/ {, j f / --=i
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 (~
4646 Dakota Street S.E., Prior Lake, Minnesota 55372