HomeMy WebLinkAboutPlumbing Permit 03-0890
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
a-b-6~ fiT
ADDRESS
15:1.51
In; rr"xL'f (.It.. 0..1.
CONTR.
OWNER
PHONE NO.
PERMIT NO.
.'? -8r()
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 EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
^~~ "'<<~I~,
COMMENTS:
/
""ORK SATISFACTORY, PROCEED
o CORRECT C ION AND PROCEED
o CORREC W K, ALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
lREMENTS ARE FOR YOUR PERSONAL HEALTH.{ SAFETY!
lNSNOTI
CITY OF PRIOR LAKE PLUMBING PERMIT
. Date Rec'd
q'lease lVDe or print and sign at bottom)
ADDRESS ZONING (office ",e)
'/')dSl //7/~.tc.J""Y ,#~/6$f CT
;~: ~::y I PERMIT NO. 0 J _ 9-<Jr)
J. Yellow Applicant L :J 0 -,
LEGAL DESCRlPTION (ollice use only)
LOT V BLOCK If ADDITION IJJ{ /vV) -1'Y1CVY/tV ls,f
OWNER
(Name)
PIDaS"-~7(..- ()38-{)
(Phone)
(Address)
APPLICANT
(Name) LA"ee.5/I:U; ,/l~86 'i!- /7'76
(Address) /.;J'/ 67 2/"v,e"l.IJ At/L
(Address)
(Contact Person). C4~ L
<\PPLICANT SIGNATURE d/ ?/e.u.~
(Phone) 9S;; - 39'/- /600
...5'/I(//76-1:..;t4A../ SS"37f'
(City) , (Zip Code)
(Phone)
<f H-~ c::
6'h>c)/o 3
DATE
APPLICANT PLEASE COMPLETE BELOW
[ Quantity I Type of Fixture Quantity I Type of Fix
i I Bath Tub with or without shower Rough-ins
I Dishwasher . Water Heater
I Floor Drain Water Softner
I I Lavatory (Bathroom Sink) Stand Pipe (Washing Ma
I I Laundry Tray (lor 2 compartment sink Sewage Ejector
I I Shower Stall Backflow Assembly
I I Sinks Backflow Assembly Test
I 1_ Bar Sink j Lawn Sprinkler
I I Water Closet (Toilet) Other
ture l
I
I
chlOe) I
I
I
I
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 Penn it #
(Office Use Only)
This Application Becomes Your Building Permit When Approved
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
,-?9. So
.50
/.; 4'C>
..,.&>.
Building Official
Date
I Paid '.,....--
i-IIJ '
I Date7~ -/- j
Rece\pt, NO.r._ ,,/
,'LlL/y L/...-,
By , v
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24 hour notice for all inspection, (952) 447-9850, fax (952) 447-4245