HomeMy WebLinkAboutPlumbing Permit 09-0122
DATE TIME
CITY OF PRIOR LAKE ~ L~!rfj
INSPECTION NOTICE SCHEDULED
ADDRESS I 'l7fBJ0; ~~~
OWNER CONTR.
PHONE NO. PERMIT NO. e; - I"L? _
o FOOTING o PLUMBING RI o EXIGRAD/FILLlNG
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL ;~~
o SITE INSPECTION o MECH FINAL
COMMENTS:
- ,f\ ("""'"l.
(ll()S~~ ~ -tJ ;I
""'l'
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORREC~K, CALL FOR REINSPECTION BEFORE COVERING
Inspector: lJ-/I) Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH.{ SAFETY!
INSNOTJ
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
3 . 3 0 . 0,
(Please type or print and sili:n at bottom)
ADDRESS
rrllto AAMSh\;e1t1 L-n,
. .
LOT
LEGAL DESCRIPTION (office use only)
BLOCK
ADDITION
C',.J ,
LlJ.P i Y\ .
OWNER \ A. /.
(Name) V"L'\ h~
(Address){ S t1.{Y) e }
Champion
651-365-1340
.x>r'A'dQQQ~ KO. #100
Eagan,'Ml't55123-1339
(Contact Person) _ ~I'i S 0 i-en
APPLICANT SIGNATURE . - ~~
t/ ."
APPLICANT 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)
APPLICANT
(Name)
(Address)
Quantity
<--p( I Dr LCLkP j
J
1. Blue File PERMIT NO
2. Gold City . 0 a, 0/72..
3. Yellow Applicant I. ~
ZONING (office use)
PIDZS.3bO. ()1'Z... 0
(Phone) gs ~ - 4-iD- k17L-
I Y11,\J < 5537'2/
(Phone)
(City)
(Zip Code)
(Phone)
DATE
3-1'-1-01
Type of Fixture
Rough-ins
Water Heater
Water Softener
Stand Pipe (Washing Machine)
Sewage Ejector
Backtlow Assembly
Backtlow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $49.50 minimum Residential, New One & Two-Family $149.50
Residential, Additions & Alterations $49.50
(Office Use Only)
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOT AL PERMIT FEE $
This Application Becomes Your Building Permit When Approved
Buildine Official
Date
L/q.s.J
.50
'2XJ. Q)
Paid 50.00
Dates. 30. () i
Il
Re1J1NO. 57Z.94-'
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U
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
3740 r
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