HomeMy WebLinkAboutPlumbing Permit 09-0065
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS 1 t:;S {p R
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CONTR.
OWNER
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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DATE TIME
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o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
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)1!..WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORR{1j~eK' CALL FOR REINSPECTION BEFORE COVERING
Inspecto. J 1) Owner/Contr:
f
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
Date Rec' d
I. Blue File
2. Gold City
3. Yellow Applicant
3.3,09
i
I PERMIT NO. 0 C;. 0 D ~.t
CITY OF PRIOR LAKE PLUMBING PERMIT
(Please type or print and sil(n at bottom)
ADDRESS
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ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
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(Address) \.. ~ {h( } \
APPLICANT
(Name)
. (Phone)
95 ~- r:n- t..f-~3
5S/~71-
(Phone)
(Contact Person)
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651-365-1340
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~E .~55123-1338
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,
(City)
(Zip Code)
(Address)
(Phone)
2.- L'-/- (if
Quantity
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APP~ANT 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)
Type of Fixture
APPLICANT SIGNATURE
Rough-ins
Water Heater
Water Softener
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
, Backflow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
Industrial, Commercial & Multi-family I % of job cost with a $49.50 minimum Residential, New One & Two-Family $149.50
Residential, Additions & Alterations $49.50
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
4'ISb
. .50
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(Office Use Only)
Buildin!! Official
Paid50. ifD
Date 3. 3. (J 1
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
Date
ReceiPtNO.572.5~
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This Application Becomes Your Building Permit When Approved
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