HomeMy WebLinkAboutPLUMBING 07-0260
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS . '2cr~ l
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
lLu~
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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DATE
cJ ar,/ OJ
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TIME
o 7 _ 0 l(O 0
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
J1_AS~INI; ~IR TST _
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rORK SATISFACTORY, PROCEED
o CORRECT ~ION AND PROCEED
o CORRE9f W~FJ1 CALL FOR REINSPECTlON BEFORE COVERING
Inspector;! / L '--) Owner/Contr: .
C.4JLL 4H7JJSO FOR/HE NEXT INSPECTION 24 HOURS IN ADVANCE.
CO~EQ~/RE~TS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
/ INSIVOTl
�ic pR �O� Date Rec'd
� � --� OF OR LAKE PLUMBING PERMIT
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C� ���/"" � 8��� File PERMIT NO. � � b�
fj z c�ia c�ry 7�. 2
3 Yellow Applicant
lease e or t and si at bottom
� ADDRESS � � ZONING (ofl�ice use)
G -E�� a r ��'� �lS'.�
LEGAL DESCRIPTION (office use only)
LOT I BLOCK � ADDITION �J • � d� rd ,4 � ..� , PID �$y ��'f •
OWNER /
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(Name) G �1 • �� �b !'Y� � ��/ �� ,� t►J �'�2.._- (Phone) b � Z ,b C 1.,� ��
(Address) 5
APPLICANT � / I � � � � Q �
(Name)� � . ��/� v� rt'�Z— (Phone) b
(Address) S�� �
' (Address) (City) (Zip Code)
(Contact Person) M (Phone)
APPLICANT SIGNATURE DATE �� � O' � 7
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fizture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (1 or 2 compariment 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 1% 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 $ 3�I• sd �''
STATE SURCHARGE $ .50
TOTAL PERMTT FEE $ D D
(OfTice Use Only)
This Application Becomes Your Building Permit When Approved Paid Receipt No� s
,,L D. eo
r Y'.,2.�d�N '�/2.�v/6 7 Date By
Building Official T Date 2�0 O�
24 hour notice for all inspections (452) 447-4850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714