HomeMy WebLinkAboutPlumbing Permit 03-0862
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
OATE TillE
&,--y
ADDRESS
(7 })-1 _t1I//"; 11 ujr
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OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
-
-
-
-
-
PERMIT NO.
~-lrC 1..
CONTR.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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o ElUGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
-
~---
-
-
-
-
-
-
o WORK S... TISFACTORY. PROCEED
o CORRECT ...CTION AND PROCEED
o ~7"'.-''''"'''''--
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Inspeclor: D _ Owner/conlr: -
CALL 447-9850 I;QR THE ~e.XT INSPECTION 24 HOURS IN ....DVANCg.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETY!
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LEGAL DESCRIPTION (office use only) {
LOT.;z BLOCK 3 ADDITION .I f1 ~
OWNER J - I} ~II. I . . /)..
(Name) LW\'. 1'VL'i-V\...U.ll Y\.. I'\.J....VO
~
~ _ ~fch,
lo\4 ,7:>W A~>t ~ I
(Addr'R) -
(Contact Person) lJeJtUIl.ll)
'PLICANT SIGNATURE ~. \. ~
(Address)
APPLICANT
(Name)
(Address)
Quantity
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
;:: ~::y I PERMIT NO.O '2 ~ 0./ l
3 Yellow Applicant ~ t'\ C(? ~
_ (Phone)
u5/-t;?5/tJ-93d'f
(Phone) _ (old - go, ' 5) I..oD
H~\\I\ 65350
(City) (Zip Code)
~
(Phone)
DATE
OMPLETE BELOW
Quantity I Type of Fixture
. Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
'bL _ Lawn Sprinkler
Other
APPLICANT PLEAS
Type of Fixture
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)
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 $
I~
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.~(L:v
.5,0
yf). UO
...LOffice Use Only)
'his Application Becomes Your Building Permit When Approved
Building Official
Date
Paid j I
l--f /) -
Date 7-1-.3
ReceiU~X'3 -~
By
~./
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
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