HomeMy WebLinkAboutPlumbing 03-0928
DATE nile
CITY OF PRIOR LAKE 8-/3~
INSPECTION NOTICE SCHEDULED
ADDRESS <~/S? ,,&l,~
OWNER CONTR.
PHONE NO. PERMIT NO. 7_ T:J~
o FOOTING o PLUMBING RI o EXlGRADIFILUNG
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RJ
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL ~<t~E~~
o SITE INSPECTION o MECH FINAL
COMMENTS:
~ORK SATISFACTORY, PROCEED
o CORRECT A ION AND PROCEED
o CORRECT . CALL FOR REINSPECTION BEFORE COVERING
Owner/Conlr.
Inspector.
o FOR THE NFXT INSPECTION 24 HOURS IN ADVANCE,
QUlREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETYI
"",",,,
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
7./1-6)
I. Blue File I PERMIT NO I
2 Gold Ci<, . 67-0 C; ?/'A
3 Yellow Applicant VV
,~ lease'!vp!: or orint and sign at bottom)
ADDRESS
'3/5 2... ~ O~ C!14 r 7I€A,t. /4:/ /<../ .
ZONING (office use) I
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID ZS. :rez.. .04-7.c)
OWNER
(Name) -r//1III
J.k;/JMf -
- ,
(Phone)
I
,61t .2"37 ~ *3~~
(Address) .s......~
APPLI CA:r:u: "J I A
(Name) J )~...\~ W'e.N:x.. nrA""~--l - J (Phone) ~5"&-. t..J...,o.f'lC>V'J~ .
(Address) (,I'/- ll'fJ b s: W ~, /'ohp:./ehSe>N ,UAI. ~~~S2l.
(Address) (City)
(Contact Person)J)p.lI\v\\'\. (Phone)
(Zip Code)
APPLICANT SIGNATURE
~'JLe-
5A"H~
DATE 7 - //-CJ3
Quantity
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)
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backtlow Assembly
Backtlow Assembly Test
Lawn Sprinkler
Other
I
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% ofjoh cost with a $39.50 minimum
Estimated Cost $
200-
Residential, New One & Two-Family
Residential, Additions & Alterations
Building Permit # () J - () f ? f'"
$99.50
$39.50
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.50
(Office Use Only)
This Application Becomes Y our Building Permit When Approved
Building Official
Date
pai~ ~ W
Oats., 1/ 7
/, .0,-.
ReceijPt NOH/!5
By
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