HomeMy WebLinkAboutPLUMBING 07-1064
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
/1
fJ / J.J.AVJ e-
\I r
SCHEDULED
DATE TIME
1(- 7'c/7
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Lv-;/!OV Phq L l-t
CONTR.
PERMIT NO.
7-fO&L./
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
~GASLlNE AIR TST
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~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOW, :riR REINSPECTION BEFORE COVERING
Inspector: jl v,r./ Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
CITY OF PRIOR LAKE PLUMBING PERMI.
Date Rec'd
(Please type or print and siftll at bottom)
ADDRESS
.5'-1 u :i" i/\/J '/ / Q11J
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
/i1r,
(}'9fl c.-l (J. '
?7,~C
(Address)
APPLICANT iJ I ---r: f}j
(N ame) 'ff-A L) / ~ (\ry L -< 1f1// pI\ {)
7 J 0 ~ Yr.J(,G {^ Ir\
(Address)
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,
(Address)
(Contact Person)
II/Io/en
~.:~ ~:~ PERMIT NO. 07-/01. L.J.
3 Yellow Applicant ((J -}
ZONING (office use)
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Tr-
PID
(Phone)
(Phone)
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(City)
(Zip Code)
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/1 /J-- / (Phone)
#tp<---f~. DATE
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture
Bath Tub with or without shower
Dishwasher
I Floor Drain
I Lavatory (Bathroom Sink)
I Laundry Tray (lor 2 compartment sink
I Shower Stall
I Sinks
I Bar Sink
I Water Closet (Toilet)
APPLICANT SIGNATURE
Quantity
I
,
I
Quantity I
I Rough-ins
I Water Heater
I Water Softner
I Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
I Backflow Assembly Test
I Lawn Sprinkler I
I Other t.,(;.'Jt.\.x 0...."')/11)0;0:;,,) 'Syrfe^\
J- 9tJ..5 it',.} ~ -Jo ~J~"tbp,
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Type of Fixture
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
"'.......
J e'"1 00 1I./
Estimated Cost $ -'- -
Building Permit #
3q.5o
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
Paid 1cJ,.oO
Date II/(p/o 7
I
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
(Office Use Only)
pplication Becomes Your Building Permit When Approved
'--~
-11,/&/0 7
Date
Building Official
.50
L.!(J,OtJ
Receipt No. 51( F,!~
BY~(