HomeMy WebLinkAboutPLUMBING 08-0645
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS , (/2 C??
OWNER
PHONE NO,
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
SCHEDULED
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C~NtRo
PERMIT NO,
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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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~ORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
LL FOR REINSPECTION BEFORE COVERING
Owner/Cantr:
o FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
~ REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(Please type or print and sign at bottom)
ADDRESS
142S() !eVTc:;e,e.S 5/tzeCr tV: t;.-
1. Blue File PERMIT NO
; ~~:~w ~~~iJcant . 0 8 r 0 (0 +5-
ZONING (office use)
te/SD
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID2S 930. 07,.0
OWNER
(Name)
DUA tI~; .i ELl/vorl
Ii " LEy
(Phone) q 1.>- 1..- 4 L/ 5- L/ J./ r!'
(Address) 14 1,)"0 l<. u'fGe. le5 rf. tiE,
PRIOR. ~AklE;I1AJ
.,,~ < 7 2--
APPLICANT
(Name) D U AN( Ii /?; L l- Y
(Address) J4:l.s{) /S1:J'T'a p/<..S sf. N B
(Address)
(Phone)
Pit, oft LA k 11
(City)
q S ~- 4L/.s- L/ L.l tj' /,
/1,.1
~s 377.-
(Zip Code)
(Contact Person) -:J) U A tJ IF R, L l 'I
APPLICANT SIGNATlJRE fj~__ ~......
I
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture I Quantity
Bath Tub with or without shower I
I Dishwasher I
I Floor Drain I
I Lavatory (Bathroom Sink) I
I Laundry Tray (1 or 2 compartment sink I
I Shower Stall I
I Sinks I
I Bar Sink I
I Water Closet (Toilet) I
(Phone) q 5 Z - LI " S ~ t./ 4 ~ (,
DATE --R~ IL- 0'
Quantity
Type of Fixture
x
Rough-ins
I Water Heater
Water Softener
Stand Pipe (Washing Machine)
I Sewage Eiector
I Backflow Assembly
I Backflow Assembly Test
I Lawn Sprinkler
I 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
ST A TE SURCHARGE
TOTAL PERMIT FEE
$ 4-q. 50
$ .50
$-.50. a 0
(Office Use Only)
Buildine: Official
Date
paid.s-v. f/Z}
D~ () ~
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RetiNa. 52, 572-
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This Application Becomes Your Building Permit When Approved
24 hour notice for al\ inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E" Prior Lake, Minnesota 55372