HomeMy WebLinkAboutPlumbing Permit 09-0257
~Eh TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED ZZ--' 1/6-
4\30 Wl~
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
CJr/zS7
COMMENTS:
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
~PLUMBING FINAL
o MECH FINAL
. ~{4>VC7D
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
C l-OS6- ,:-(~
'fJ.....WORK SATISFACTORY, PROCEED
o CORRECT ACTler AND PROCEED
o CORRECT ~ff:-1LL FOR REINSPECTION BEFORE COVERING
Inspector: ~.I~.( Owner/Contr: .
. 1-
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
1. Blue File
2. Gold City
3. Yellow Applicant
PERMIT NO'1.2S /
(Please type or print and sign at bottom)
ADDRESS
4\ ~o v.J v0 ~(, C tfL .
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
~=R it":1 ,1!: ~~Id
(Address) Y \ 30 ~. tvSL Sc:.,l\G C: f ~ '^
X APPLICANT ~
. (Name) fl~1\..1 Sc::'~
r ("'-u,a 'U\ k'\.. (-t"
(Address) ~ ') \.., , \ .7 vv .
(Address)
II I E-
IVe .
(Phone) b / :l- - 7 of,'" 7:; 7 t
(J/:v/' L ~ Ie. ~^
(Phone) -f~.)-
~ \./ r, c..-< In $\.
(City) .
l{I..{ 1 ~ f 0 .?- S-
t-~'] )~
(Zip Code)
\. (Contact Person) W 4
~; APPLICANT SIGNATURE
SA'1~
(WIOJ. .~.Jt. A
.v
(Phone) ~CJ- f 0 (- Sf;) c..
DATE C; -{ t1-~ Cf
- .
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
X Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (1 or 2 compartment sink Sewage Ejector
Shower Stall I Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
.~ Water Closet (Toilet) 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
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
4-1.:;-u
.50
t:)O. ...
-------..~
This
Paid .,-r)
-y..;--.,f
Date r-/ I
Official. Date J "1 &1
~4 hour notice for all inspections (952) 447-9850, fax (i2)' 4414245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
Receipt No. t:;'1~.(--
By 4JU \-,