HomeMy WebLinkAboutPlumbing 03-0785
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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
w;x;.. LL.M~
COMMENTS:
DATE TIME
'?~7~5
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
I?v.?
~WORK SATISFACTORY, 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..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .t SAFETY!
IN""'"
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File
2. Gold City
3, Yellow Applicant
I PERMIT NO. 03 -16';1
(Please '!'ype or print and sign at bottom)
ADDRESS
5.3 25" ohoYe J;-ai / Ai. E.
ZONING (office use)
tc I SO
LEGAL DESCRIPTION (office use only)
IJ--t /3 ,/1 +/
. LOT BLOCK (ADDITION / I tJ1U1
JJ<<YU2 @~
PIrQS-() t./{) -6 Id.- - 0
g;-::e~~rleA"~()y): H a.N I ClAA
(Address) 532S- ShO'f"e T"...~/ N. c.
(Phone)
(q52) <1'-/5 - S'f%
APPLICANTl I \ \ '1":>\ \
(Name) l"-IOf'DlllW\ r IUNll\Dh')~
(Address) 2<705' UJa/he./d Ihre. ~".
(Address)
W1pls
(chy)
((,12);527- 403]
S5'1()'i
(Zip Code)
(Phone)
(Contact Person)
"PLICANT SIGNATURE ~~ ~
(Phone)
DATE
~ft.ld 3
Quantity
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (I or 2 compartment sink
Shower Stall
Sinh
Type of Fixture
I
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I
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REQUE~1; F9R ~~NA,",
INSPECTiO~ ~E~'T 1'~
Industr HOMEOWNER 8/19/03
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
..1 a $39.50 minimum
Residential, New One & Two.Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Penn it #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERNUT FEE $
3'l.S-O
,50
1-/0.00
(Office Use Only)
(l'his Application Becomes Your Building Permit When Approved
.
Building Official
Date
I Paid .~..v. ----
()p q(),
I Date t~ /6-iJ3
ReiJlJ(~
B ' .
~
il
14 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714