HomeMy WebLinkAboutPlumbing 03-0666
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
ADDRESS
)aloe:;
L~~~~~~
OWNER
CONTR.
~
PHONE NO.
PERMIT NO.
)- r
"In( n
"
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
o EXIGRADIFILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
)ft.- -~.
COMMENTS:
'\.( WORK SATISFACTORY, PROCEED
- ~RRECT ACTION AND PROCEED
o CORREITRK, CALL FOR REINSPECTION BEFORE COVERING
Inspector. \I 'Q Owner{Contr:
CALL 447-9~' FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
msNOn
--~~_.- . _____.._. _."__n ___.0.". .'_'___"h.__~~__ ___ _'___~._._"____.._.__._..__.,...
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File
2_ Gold City
1 Yellow Applicant
I PERMIT NO'O:3 - ~ t6~
ADDRESS
30bS
Lakt> , I-lCUlVYl C~r
,
ZONING (office use}
!? /5D
(Please.!VD~ or 'Print and sign at bottom)
LEGAL DESCRIPTION (office use only) ,
LOT 'I BLOCK I ADDITION Ylml!u/ m/.AtJ~ 5S/- d4ID ;?,S /31/ '" 001,-0
g,":'~R 1>~ nt"~ . f\f\ M"k.
I .
(Address) 30 r.,~ La/( t> 1-1 aA/e..n Co-u-rt
(Phone) (15l) '/'I()~12{'L
APPLICANT l \ L \ , ,. ~ hl'f\C,
(Name) N.QIO\OVV\ r\l..vllll\l~
(Address) 2'105 611M-{te. /01 Ave. t; ().
(Address)
(Phone)
Mp\s
(City)
{(gll) f?21- t./D33
~~t/dl
(Zip Code)
(Contact Person)
(Phone)
l'PLlCANTSIGNATURE O~~_ -
-~ -
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)
DATE
512'llo~
Quantity
Rough-ins
Water Heater
1
I
I
Water Softner I
Stand Pipe (Washing Machine) I
Sewage Ejector j
Backflow Assembly -.(;,., 1a.uJl\ ~N\~
Backflow Assembly Test I
Lawn Sprinkler I
Other J
Type of Fixture
I
II:
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 $
<~<1. S-o
.50
'to .0 0
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
I Pai~ ij,!}.--
I Date 0-1-{)3
ReceiEl~5 (p ~
By qv
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714