HomeMy WebLinkAboutSewer/Water Permit 02-0565
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
5. 7. of
ADDRESS
43 f5 (!AJc.,(),rC/IVO
~'I
OWNER
CONTR.
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
COMMENTS:
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o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
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o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
lNSNOTl
SCHEDULED
DATE
5hl /Ol-
TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
A,'T_
311S'
ADDRESS A 3a s C:O(.. 0 iZ~ ("')
OWNER --bf04 N~'( DANI~i- CONTR. 5A,",,6
PHONE NO.
PERMIT NO.
oz..-~<a6
o FOOTING
o FOUNDATION
o FRAMING
o I NytJ LA TION
O..,.P1NAL
SITE INSPECTION
o PLUMBING RI
o MECH RI
~WATER HOOKUP 01011..'(
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
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o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector: ~ Owner/Contr:
Y )
.CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
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CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
Date Rec'd
(Please type or print and sign at bottom)
ADDRESS
I. Green File l PERMIT NO
2. Yellow City .
3. Gold Applicant 02.. -Sf,CS-
4.~ g <;'" C:OC <.. J(!. /~ 0
ZONING (office use)
f2--z
L~--f~ DESCRIPTION (office use only)
LOT~ BLOCK ( ADDITION ().;~,- ~ 06--
I
Auo I l(crJPID 2)'-GbY-013-<o
OWNER
(Name)
j~;ff~D^~ IcL
f ~ S') 5- C.C)(.. ,,<) I~O 0
(Address)
, (Phone)
+47 - 4<.".,2-;
(Address)
.,-.... .
t., L -
(City)
(Zip Code)
APPLICANT
(Name)
5.4cY\E- .
(Phone)
(Address)
(Address)
(City)
(Zip Code)
(Contact Person) /~ /; .,./\ ,;; (Phone)
APPLICANTSIGNAT6{ ~ "'cf{,f~ DATE _S - "J. f - 6'~~
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APPLICANT PLEASE COMPLETE BELOW
..
Size of water service /' inches.
Location of any couplings from structure feet.
Type of sewer pipe. 0 ABC 0 PVC 0 Cast Iron
Estimated length of sewer line feet.
Clean out (if required) located at feet from structure.
Estimated Cost $
FEE SCHEDULE
$35.50 Industrial, Com'l & MuIti-famil~ cost with a $39.50 minimum
$17.50 Water connection only ~1-0 .'
Building Permit #
Residential sewer and water line connection
Sewer connection only
W A- \E{L CNe'..1 SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
ll.. 5U
.50
tB.,lJ-
(OfficefJjse O~) ~ II ~ I
ThiS. P. . C~OI . . ;t(;::y 0 uilding Pft"~ it W~n App,oved Poid j 11.010
c'/., ,/ .1/\ ) Z I //J Z-- Date J /
f Building Officla( ~___ ) 'Djte ~/2i / C) 'L-
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
Receipt No.
42.074-
I By ~J?(f