HomeMy WebLinkAboutBUILDING 08-0469
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS 13~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
\cO JNSULATION
)l( FINAL
o SITE INSPECTION
COMMENTS:
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DATE
-#~
Lk \..r-
SCHEDULED
B~
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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J /'lL ""\.. \.U
TIME
{f - 4{p i
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
X WORK SATISFACTORY, PROCEED
o COR~RC CTION AND PROCEED
o COR CT O~K, CALL FOR REINSPECTION BEFORE COVERING
InspectC'r: ,'fl OWner/Contr:
CA~L ~~50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
'-J V
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
ll'iS/'iOTI
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
1. Blue File I PERMIT NO
2. Gold City .
J. Yellow Applicant
8 - oC{~ 1 I
(Please tvoe or orint and sie;n at bottom)
ADDRESS
t'?J22D PI k.e LiL. Trtti I
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
pm
OWNER
(Name) ~mtA 3D\;~dt11c -CClmf K-ICI'p'l
(Address)
(phone)
APPLICANT
(Name) tVltll'n hV\t, vi Hm\7i~
(Address) S0.51 Mradowlan~. Ull'1c.
(Address)
(Contact Person) MMt HtmtlYlI1y\
APPLICANTSIGNATURE <-filJ ~
(Phone)
Pn Dr Let ILL;
(City)
vlG2. 44 D. ~2.l..d
rJCj~?I2-
(Zip Code)
(Phone) t;il- &ll.1- l1L, 0
DATE 7//(;// ~
Quantity
~.
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (1 or 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
Type of Fixture
Rough-ins
Water Heater
Water Softener
Stand Pipe (Washing Machine)
Sewage Eiector ~ I iJi Stti-tioVl
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $49.50 minimum Residential, New One & Two-Family $149.50
Residential, Additions & Alterations $49.50
Estimated Cost $ 11.IJ50, DO
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
1 "1/;.5D
.50
111.00
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
Receipt No.
Date
By
BuildiDl~ Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372