HomeMy WebLinkAboutPLUMBING 07-1015
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
fSl/1
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
SCHEDULED
~-~ ~~i-
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
L,aWYl,
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---
DATE TIME
If -( -?)
/-(O/:s
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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LWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PR
o CORRECT WORIVtCAL~ REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
10. Z2.. 07
(Please type or print and siltll at bottom)
ADDRESS ZONING (office use)
~.:~ ~I~ PERMIT NO. 07/0 /S
3. Yellow Applicant , .
/57/9 K/l)6E/1?o/l/T AvE S-:E.
11< lOll... L ~ /V?/../
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
I OWNER
(Name) M/CHYr6-
Ct</E60
. (Phone) CJS2 - 2L/o-- 2 33 ~
(Address)
, APPLICANT
(Name)
(Phone)
(Address)
(Address)
(City)
(Zip Code)
(Contact Person)
(Phone)
.-? -
~~-./ ~ -----/
APPLICANT SIGNATURE --- ~ ~ ~~ /
e
DATE
/0/'2Z/;7.
.
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture
Bath Tub with or without shower
I 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)
Quantity
'c /J
T
I Type of Fixture
I Rough-ins
I Water Heater
I Water Softner
I Stand Pipe (Washing Machine)
I Sewage Ejector
I Backflow Assembly
I Backflow Assembly Test
I Lawn Sprinkler
I Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Penn it #
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office use1jjD1Vk "-
This Ap c t <<omes ~ ou' Bu;ldlug Pecm;tjwheu ";P'UVed Paid -10. 0 0
~ 10/21-/0, Date
, ~1diDg Official" l Date . /a. Zl.. 07
'- ~tice for all inspections (952) 4~7-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
$
$
$
:39.5[)
.50
4-0.01
RecefNo'S4gS/
I BY/) .
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