HomeMy WebLinkAboutPLMBG 08-0800
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE .
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TIME
It) . ~o
ADDRESS
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Wlt..;) S Pr'tt1r1-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
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o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLltiE AIR TST
o MECH FINAL 0 r /
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COMMENTS:
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V \AlOR&/" ~ A T1S"A"-r""", _______
p-~. no ""1"\ II r '" I Un., . rn.v\,eJ::.U
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALl FOR REINSPECTION BEFORE COVERING
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,
Inspector:
Owner/Contr:
.CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
Date Re~'d
CITY OF PRIOR LAKE PLUMBING PERMIT
~. ~~~ ~~:~y I PERMIT NO. ()8, 0 ~ O?l
3. Yellow Applicant 0 U
(Please type or print and siltn aLt bottom)
ADDRESS
ZONING (office use)
\l\\l,?:>
\S,\as
r ~A- \"
NvJ
553 7 ~
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
D~ - At 0\ e \ J C\
5 "^-5 Q.y\ q
(Phone) 9'S.J - LID 3 - '70(j J
(Address)
\,-\Il:,") W.dJs Po.\~
N0
APPLICANT
(Name)
(Address)
W~'L:L:.ltjAN VVA I t:H GUNOITIDNING
.6030 CULLIGAN WAY
M.~~EiTONKA, MN 55345
(95~) 933..7200
(Phone)
(City)
(Zip Code)
(Contact Person)
~
,
~r.-i ~4
J
(Phone)
APPLICANT SIGNATURE
DATE
q-I~-O~
Quantity
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
Type of Fixture
Rough-ins
Water Heater
Water Softener
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backtlow 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 $ ;)OQ . lj ()
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
~9. 50
.50
50 . \\ \\
(Office Use Only)
Buildin!! Official
Date
paid60.00
Date/O, (,~. (/ y
/l
Re~1t NO.S7P90..3
B '
7
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 0
4646 Dakota Street S.E., Prior Lake, Minnesota 55372