HomeMy WebLinkAboutPLMBG 08-0543
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS (!:Jo?x:J
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
(- )
./ ~p
SCHEDULED
~i l~/
,
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
n 0.
~ \-,'\.p
gr;;/08
I I
TIME
~ - 5Lf3
/
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
rp ASLI~E AIR, TST L--
, 'J~r~ -iI:hP~
/ -
;/wORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRE{ET . OifA-L FOR REINSPECTION BEFORE COVERING
Inspector: r } v-; Owner/Contr:
CAL 7-U FO~E NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQ~NTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
/J'/SNOTI
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(Please type or print and siltn at bottom)
ADDRESS
01o'"XJ ftUr/CtV{V) St'ffeS
I. Blue File 3
2. Ciold City PERMIT NO'()8. C)5d_.
J. Yellow Applicant ,r
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
~=R t-ttUold f1jJRJt
(Address) l Sa m Q )
(Phone) 0L~ - &(). 51 tl
~i(Ylti.~/.M(\/. ~5~7 ~
~ ., ---- ~
APPLICANT
(N ame)
(Address)
Champion
Rt:;1_~Rt;_1~.1n
3670 Dodd Rd. #100
~?~"'n. I\i1I\J t:;t:;1?~_1~~Q
(Address)
\4 i -s ("") i(~"
(Phone)
(City)
(Zip Code)
(Contact Person)
(Phone)
PLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher I Water Heater
Floor Drain I Water Softener
Lavatory (Bathroom Sink) I Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink I Sewage Ejector
I Shower Stall I Backflow Assembly
I Sinks I Backflow Assembly Test
I Bar Sink I Lawn Sprinkler
I Water Closet (Toilet) I Other
DATE
l-\~.-ce)
APPLICANT SIGNATURE
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 $ '1-aj':))
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.~;I . C) l.L
.50
~- -
)tJ . n.)
/\
I
tetiPt No.Cb J 1 t
yY
~
"1"\ ~, J...
') ~ ,~\f)
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Buildinl! Official
Date
Paid r;l), (;V
Da~ r./
- J,."LY A.. X
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372