HomeMy WebLinkAboutPlumbing 03-0734
,
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE
TIME
~-~
ADDRESS
l~q'1~ lViIJ-6116S 1l---
OWNER
CONTR.
'3 - '/'3,/
PHONE NO.
PERMIT NO.
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
9,(~/{/-1'-
COMMENTS:
o EXlGRADlFlLLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
~l '(~ L
V 0 St'. F<
./
~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~LL ~/~SPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
<NSNO"
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .{ SAFETY!
_..__.u.____._________.._____...'__._ .
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
&. (P.Q3
I. Blue File I PERMIT NO ill
2. Gold Ci<y 'O!3 -()7.
3, Yellow Applicant , __
e or rint and si at bottom
ADDRESS _ .
IlPq~(p \N JJL.;rvw~') ,y~
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PIDZS- 3/8- 02J?~O
OWNER IJ^rr
(Name) t't~ ltJJine PUTT\'V\ll..t'\
(Phone) Cf5d.4Lf 1- 51J.i
(Address)
APPLICANT
(Name)
(Contact Person)
~~ \Nfd~
U 14 b ltlL \Jt S\JJ
(Address)
I\lY\.JIlJJ)
(Phone) lP_l;) -~D' - 5;)lPD
I-lU..:kN.J\JyM 553 ~
(City) (Zip Code)
(Address)
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall \ Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
APPLICANT PLEASE COMPLETE BELOW
(Phone)
50JvV
APPLICANT SIGNATURE
DATE
FEE SCHEDULE
Industrial, Commercial & Multi-family 1 % of job cost with a $39.50 minimum
Residential, New One & Two.Farnily $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Penn it #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
3Q.50
.50
LID,OlL
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
.W
Dattp. & . 0)
Receip~,
By
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714