HomeMy WebLinkAboutPLMBG 08-0625
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
I~/~{ h'{~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDA nON
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
COMMENTS:
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DATE TIME
Wo?J
8 - &ry;
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
jD GASLoINE "I~ TSjJ
,l",.r:f ~
'-J
J'..WORK SATISFACTORY, PROCEED
o CORREtfflT N AND PROCEED
o CORRE WOR ALL FOR REINSPECTION BEFORE COVERING
Inspector: h ~ Owner/Contr:
CAL~7-~O~OR~ NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE~EQUI~TS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
1. Blue File PERMIT NO z.$
2. Gold City . O' 0,0/
3. Yellow Applicant a (t'
(Please type or print and siltn at bottom)
ADDRESS "Sf'
ilo 18/ Fi'/ tnor .c/1ivcJ
, ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER () h r, n.- .;V)Y.:) fro LCS
(Name) ~ '(-) UV.A l.,-..
'-
r'
(Address) ~ G(/f'r1. 0 J
(Phone)
Cl5~-1f<{7- 871-'5'
APPLICANT
(Name)
(Address)
Champion
651-365-'j 340
3670 [;;:.da Ro '~~:1_;:
(Phone)
Quantity
Ec1C'2r~Af~dt~)o '::2--;
y (l~/O \CX\
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J-,fV 4---",,, DATE
f! ~
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (1 or 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
(City)
(Zip Code)
(Contact Person)
(Phone)
6-1'2 0-6
APPLICANT SIGNATURE
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
$
$
$_E)o /D
/to:v
.50
(Office Use Only)
Buildin!! Official
Date
Paid SO. (jO
Date (j - () (J>,
o. t!=>. u
/J
Rece~o, ~7 0
BYJ-~
u
331-f31
C1J
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