HomeMy WebLinkAboutPlumbing 03-0918
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
J,)J~( ~~f~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
. \.1} INSULATION
AJ....FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
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DATE TIME
7:f8.~
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i
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1(" 15
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
~ t~IN+ rn:oS~, .
y L~II..- 7pLJJ5 - 3- '1' ([Y
.f.
J-C,~ 50 L
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rRK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORR T RK, CALL FOR REINSPECTION BEFORE COVERING
. Owner/Contr:
c
50 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
I. Blue File
2. Gold City
3. Yellow Applicant
PERMIT NO, j~-q/f'
(Please type or print and sign at bottom)
ADDRESS
LEGAL DESCRIPTION (office use only)
LOT 6 BLOCK c;tADDITION
/Sld-J.~ P04.4/
0-/jJ#~u, /~.
\.l~~~ ~
~
ZONING (office use)
PID ~5 -- 395 - Ode, -0
OWNER
(Name)
(Phone)
(Address)
APPLICANT
(Name)
ieDI1 (}~tA I'/~ .
7th U
,2ot? -/7 It/-V""-'2 ~
(Address)
(Contact Person) k~~ ..... /"'\ -
)PLICANTSIGNAT~RE . ~ \ ~.x.4tfj
,J~/~
(Phone)
Il~ Rf/;"
; . (t1ty)
(Phone) c... -6 C'd ~t>2~ vS- ~ 3
~~//~k;3
9":)~ <fs 3 ~3~
'~Yf
(Zip Code)
(Address)
DATE
Quantity
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
x
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 $
STATE SURCHARGE $
TOTAL PERMIT FEE $
L,q. ~6
.50
Un " ----
I
_(Office Use Only)
Building Official
Date
Paid Llo / ----
DateL__IO~
Receipt Nl/L/r;t;;D;
By ff/
'his 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