HomeMy WebLinkAboutPlumbing 03-0763
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
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:
4)$'ev ~k~
DATE TIME
~.7~3
o EXlGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~RKSATISFACTORY. 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.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
t
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 8/19,/03
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(Please tv'D!: or urint and sitm at bottom)
ADDRESS
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
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::: ~::y I PERMIT NO.A? _ 0<'7/-? I
Yellow Applicant ( J -> - / t.P.-J
ZONING (officeu,,)
PID
(PhoneJ ntri-ful- aa~
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(Address) Gr~% ~-~--V) (\~ ~
APPLICANI. r>.--n' I I A. \~ D - ~ ~ .1.,
(Name) < ~ \. ;r..DN \ () \:{lJ1 ~j\f\\Ik.-I:lt:-IL- (Phon;)1 r;::r DaD -ruLL(l I
(Address) ,~I'?J 0:t-y-wi A t4--e-,\"l:54 ~Ul~T\. I ,lJ\ ,~blll)
(Adcfress) (City) (Zip Code)
(ContactPerson;C\\.~ (Phone)'-l\~- ~-~lcWl
/,,--'PPLICANTSIGNATURE 1///0. Joj;/JtjL
/
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)
Quantity
DATE
Type of Fixture
,
,
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
Industrial, Commercial & Multi~fami1y 1 % of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Permit # ()J - 0 7" J
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
.---"--
.. This Application Becomes Your Building Permit When Approved
Building Official
Date
$ ,;2,q.3D
$ . _ _50
$ L/ () . uU
rai~. CfV
I Da~.I/. QJ
ReceiPt~
BY.f.
U ,/
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714