HomeMy WebLinkAboutPLMBG08-0626
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS .! 4 ?J2 \
OWNER
PHONE NO.
o FOOTING
o FOUNDA TrON
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED ~_/~~
I (
Oak~ ~
CONTR.
PERMIT NO.
8 - (,Q4
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
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o WORK SATISFACTORY, PROCEED
)( CORRECT AC~N AND PROCEED
o CORREf} I . CALL FOR REINSPECTION BEFORE COVERING
Inspector: ,\1: Owner/Contr:
CALL i447.~FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
----
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTJ
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
~.~~~~ ~::~y PERMITNO.oa.O,z/l
3. Yellow Applicant U (SI (.A'
(Please type or print and si2n at bottom)
ADf}l}F{SS
f'ttf -tj
CU.kjeLnd !Jeaeh /1L :Sf
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER (2rn ~ ~.
(Name) -----I.4J;dJ f-
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"::~4L).fJ.i j ~
Pr[~r La J<jJ~
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(Phone) Cj51-tJ1.7' 5robb
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(Address) ~ \eLm Y J
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APPLICANT
(Name)
Quantity
Champion
65 1-';63- 1340
3670 Dodd Rd #100
ea~A~ipo 12::;-1 J2;J
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f/ ",tP'"
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity I
Bath Tub with or without shower I Rough-ins
Dishwasher I Water Heater
Floor Drain I Water Softener
Lavatory (Bathroom Sink) I Stand Pipe (Washing Machine)
Laundry Tray (1 or 2 compartment sink I Sewage Ejector
Shower Stall I Backflow Assembly
Sinks I Backflow Assembly Test
Bar Sink I Lawn Sprinkler
Water Closet (Toilet) I Other
(Phone)
(Address)
(City)
(Zip Code)
(Contact Person)
(Phone)
APPLICANT SIGNATURE
DATE
6--Il'O~
Type of Fixture
FEE SCHEDULE
Industrial, Commercial & Multi-family I % of job cost with a $49.50 minimum Residential, New One & Two-Family $ 149.50
Residential, Additions & Alterations $49.50
Estimated Cost $
Building Permit #
j
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
41.So
,50
V)() ()u
(Office Use Only)
Buildin!! Official
Date
paid50. UV
Date
~.I5'. CJf;
Rer7No.S-z, 570
B~./
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This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
6
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