HomeMy WebLinkAboutPLUMBING 08-0095
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~AL
o SITE INSPECTION
COMMENTS:
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SCHEDULED
: )
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DATE TIME
4-q-~
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X--"- '75
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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9'WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W;~~OR REINSPECTION BEFORE COVERING
Inspector: f /I ~ Owner/Contr:
.
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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CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File
2. Gold City
3. Yellow Applicant
(Please tvPe or JJrint and sip at bottom)
ADDRESS [\ , n /I
j Gdd. ~cuLi\VJJ.i)) N I j E
LEGAL DESCRu- .l.lON (office use only)
LOT BLOCK
E:5+~~ lYY~ ~\cc-\ (phone)
j (0 ~\ 'JQ( KV'I <L-vJ [) (c)E
=~ANT D('Q~ (\ ~('O 91 um p; f//J1 (Phone) Cf17()-L/~/}-h c;r1,
(Address) ~)'5 dp)q+VL;t: l~lJ LAK6~lle 55T)ftJ
\ (Address) (City) (Zip Code) I
(Contact Person) ,jQf) f\. V /) /l (phone)
APPLICANT SIGNATURE / C/.jJAm-1./L-Z,~ DATE :s -ti -()J~
~LICANT P~A;E COMPLET~ BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (1 or 2 compartment sink
I Shower Stall
I Sinks
I Bar Sink
I Water Closet (Toilet)
OWNER
(Name)
(Address)
/
Quantity
ADDmON
Date Rec'd
3.10.oB
I PERMIT NO. 08 _ ClJ95 I
ZONING (office use)
PID
q5d-t/L!7 - 43~) /
Type of Fixture
Rough-ins
Water Heater
Water Softener
Stand Pipe (Washing Machine)
I Sewage Eiector
I Backflow Assembly
I Backflow Assembly Test
I Lawn Sprinkler
I Other
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FEE SCHEDULE
Industrial, Commercial & Multi-family] % of job cost with a $49.50 minimum
':"\Qz~ a
Estimated Cost $ \)(,J)
Residential, New One & Two-Family $]49.50
Residential, Additions & Alterations $49.50
Building Permit #
,~13 ;-0
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PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
(Office Use Only)
This Application Becomes Your Building Permit When Approved
r
Building OMcial
I Paid 50.00
Date.,3. I 2 . 08
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E.. Prior Lake, Minnesota 55372
ReceiP7 .
By
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65000