HomeMy WebLinkAboutPLUMBING 07-1010
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
to 'J-C(-c;
ADDRESS
~44
r/AvlLl/ Ii:.. C1;:;..
OWNER
CONTR.
PHONE NO.
PERMIT NO.
7-(010
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
II J- () /JrPL {C--
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
-- ---
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( I , I () SL jt <l.1 )
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'----------------
,,-/wORK SATISFACTORY, PROCEED
o CORRECT ACTIO~AND OCEED
o CORRECT,~~ FOR REINSPECTION BEFORE COVERING
Inspector: )( I Owner/Contr:
. .
~ALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
~: ~~~ ~~y PERMIT NO'07./()/O
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS
ZONING (office use)
~v;q4 ?(.,\v\Lv~.Cl, C;IL, ~.
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
\Lt Nt
~v\l~
(Phone) Q6;). - 4\.n~1111
Ol \!\C\ ('v'\CiV ~ \;0 \ ~ '\ l C\ l
.~Cl\r \L V\~ i, v
APPLICANT -::1_.( \ ';Ji l" \ \ t.. I __I A'( ~Df\,\a M ~
(Name) 0>\'\-1 ~ Y\\.~w\\J.J\~ ttl('l\t~:1 Ct~l.:' (PhOne)'" l~- l1tV- 1011
(Address) ~\Y5" O-ct vv1 U\1V\ ~ S'W()..\)\
(Address) (City)
(Contact Person) \,,~\\\ \~ ~\..t V,~\():~.J (Phone) \of, \-1'1 Cf>.. ('01\
APPLICANT SIGNAT~RE U,\\t\D'~ t'\t\)\ uJri~ DATE '0\ ~\V'l
C'(L
_ l
Sc
(Address)
'SSlOL-.
(Zip Code)
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher ~ Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (W ashing Machine)
Laundry Tray (1 or 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
FEE SCHEDULE
Industrial, Commercial & Multi-family I % of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
1:P\. t3c
.50
Ll.G. ("C
(Office Use Only)
Buildinl! Official
Date
Paid 4-0. uU
Date l 0 .1 (). C 1
Re~eiPt No. 54-8B
B,
C/o
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714