HomeMy WebLinkAboutPlumbing 03-0808
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS ~~~f.r
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED 8-1'2- 0"3 ~
\-!, \ao~ OUC'&.
CONTR.
PERMIT NO.
3 - Pf'\~
o PLUMBING RI
o MECH Rl
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST, I
51 L....,,^ ~....~
(~
I
PWORK SATISFACTORY, PROCEED
o CORRE;T ACTION AND PROCEED
o COR~;~ORK' CALL FOR REINSPECTION BEFORE COVERING
Inspect r:, __ . Owner/Contr:
C -sJso FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
\/Q .
COJ,J R~fIREMENTSARE FOR YOUR PERSONAL HEALTH'" SAFETY!
/ ,__n
.-'...- -..---..-"'." ~---,~_.,.
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(Address)
(Contact Person) J. cJ A " I r -:2 /~ /
'PLICANT SIGNATURE &..~-;
/
APPLICANT PLEASE COMPLETE BELOW
Type oCFixture 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)
(Please lY\>e or print and sign at bottom)
ADDRESS
Wt7t?JJ
fJ~~k jr!
I S;2Sb
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER L Ar i 55 (., ,j/ch611
(Name)
(Address) I )))tP WlJoJ O"'C~ If'/.
APPLICANT ~+f'a.J fJul1\bJ~
(Name)
(Address) ) <;ct I /7016 :;-+. iJ.
Quantity
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
Estimated Cost $
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
..l()ffice Use Only)
,'his Application Becomes Your Building Permit When Approved
Building Official
Date
(o.f'io]
I. Blue File [PERMIT NO I
2Gold C;'y 'C'-?-CQO~
3. Yellow Applicant U 0
ZONING (office use)
PID25-Jf?- Orl.-V
(Phone)
(Phone)
QS2 2 s Cj - q 1..2.<
(City)
(Zip Code)
(Phone)
DATE
&'-/8'-0'3
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
X Backflow Assembly
Backtlow Assembly Test
Lawn Sprinkler
Other
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Building Penn it #
$ 3'1.50
$ .50
$ 4--0.00
I Paidl'tt (IV
I Dat~ .18 (lJ
Receipt ~~-?-
By .-(
,-' .,'
~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
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