HomeMy WebLinkAboutPlumbing Permit 09-0157
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS 2~~~
Lr ( LP
I
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:
DATE
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ftlVf
TIME
'-IS?
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
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piCWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRf!)c K, CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
fJ
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
(phone) ~/d- S~ [f- JFCJ g-
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(City) (Zip Code)
_ (phone) (:? I d- 50> g- ..- 7 g-() S'
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CITY OF PRIOR LAKE PLUMBING PERMIT
1_ Blue File
2, Gold City
3, Yellow Applicant
(Please type or print and sian at' ".,. d)
ADDRESS
dCJ 3 5
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LEGAL DESCRu '.1 iON (office use only)
LOT BLOCK
ADDmON
OWNER
(Name) ,,10 AN
(Address) :J C; ~ S
Kioe7e fI.-/
S P(I f1/'7
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!2of
(phone)
APPLICANT
(Name)
.P / L,vm b f A/"C,
/7.57 I
(Address) ----'31 too 9 /7> I ~ It ve
(Address)
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APPLIcANTSIGNATURE ~k .~
1<'7
(Contact Person)
DATE
........
Date Rec'd
4- 2- i' (.1 J
I PERMIT NO. 09. 0/S--;1
,
ZONING (office use)
Pill 2 r- I J]. vi' 7. u
~/d-97/-0006
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain Water Softener
Lavatory (Bathroom Sink) Stand Pipe (Washin~ Machine)
Laundry Tray (l or 2 compartment sink Sew3J!.e Eiector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink I Lawn Sprinkler
Water Closet (Toilet) Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $49.50 minimwn Residential, New One & Two-Family $149.50
Residential, Additions & Alterations $49.50
Estimated Cost $
Building Pennit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
Hill
.50
SV" /.-IV
(Oflift Use Only)
This Application Becomes Your Building Permit When Approved Paid SO (, ()
Bulldint! Offtclal Date Dat%2- 2-, (..! - (I 9
24 hour notice for all inspections (952) 447-9850, fax (952) 447~5
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
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