HomeMy WebLinkAboutPlumbing Permit 03-1065
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
'/7t{)
([3v'r ck,t ~
OWNER
CONTR.
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
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/ /,7
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--
DATE TIME
€- .)Q~
3 -/x.s-
o EXiGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
-~
-r .
/ I
11.1
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- - - -------
/
~R~ SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK. CALL FOR REINSPECT/ON BEFORE COVERING
Inspector: II!f f;-- )()-1/!? Owner/Contr:
.CALL "'7-9850 FOR THE NEXT INSPECTll)N 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
Il'iSNQTJ
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
'i3 ,It-.V}
I. Blue File I PERMIT NO I
'Gold C;" '0'< ,(O r r"
) Yellow Applicant J IQ ')
(Please type or orint and sim at bottom)
ADDRESS
!3lJ/ R.-,P<: P.
ZONING (olli..u..)
) UJ5{)1<ff/)a:R la/1f',
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID ,35: 370. 033.0 ,
OWNER
(Name)
;/2,;/1 Ree~f"'.
/ 7 .9./5 ~u...yr /'Ja)2 ) /l me:,
(phone)
tJ.<:<- 99"0 ~</cS
, (Address)
APPLICANT./l . .::J /) '-
(Name) .1. /rCJ-JI? tJ/'1J r/k.pr//?J'nj (phone) C}c;;;.-l/b'1- 6?'/'7
(Address) <?LJ/'J? fl:Jh:/~w il.H I/lP~;J/~ PJ/1_,~5(JY<f
(A ess) (City) (Zip Code)
~
(Contact Person) ~-e Yl Yi I (Phone) C)c::;.;;2 - t.j(,/7 - (r, 99 '7
l'PLICANTSIGNATURE (/Oz*.I _~~ DATE S-- ) \- 03
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (1 or 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
Quantity
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backfl()w Assembly Test
~ Lawn Sprinkler ~
-Other
FEE SCHEDULE
Industrial. Commercial & Multi-family I % of job cost with a $~9.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $ Building Permit # Of - /065"
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
--::<;1,,50
.50
i/O. 00
(om" Use Only)
This Application Becomes Your Building Permit When Approved
Building Omcial
Date
IP~u>
I Day /2 . 0 ?
ReceiPt~ v9
By . -:L
U
24 hnur notice for all inspections (952) 447-9850, fax (952) 447-4245
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