HomeMy WebLinkAboutSewer/Water Permit 10-0143
CITY OF PRIOR LAKE
INSPECTION NonCE
ADDRESS
1 L.Vi}7 U
OWNER
PHONE NO.
o FOOTING
o FOUNDAnoN
o FRAMING
o INSULAnoN
o FINAL
o SITE INSPEcnoN
COMMENTS:
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SCHEDULED 11'1),1. fo,.
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CONTR.
1
PERI8T NO.
II) - 143
o PLUMBING RI
o MECH II
it. WATER HOOKUP
II( SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGMDIFILUNG
D~
o FIIII!PLAGE RI
o FIRIP" .,~ FINAL
o GASUNE AIR TST
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C WORK SAnsFACTORY, PROCEED
)!.. CORRECT ~ AND PROCEED
C CORREG'T vIo1ftf. CALL FOR RElNSPECTION BEFORE COVERING
OwnerIContr:
FOR ,...."= ~'EXT INSpl:~ 24 HOURS IN ADVANCE.
CODE HQltf"''C'I',.EN'l'S..dE FOR YOUR PERSONAL HEALTH" SAFETYI
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\...11. i OF PRIOR LAKE
SEWER AND W A.lI!,R PEDllI
Date Ree'd
~ . 18.10
CPlcue tYDC or Driat _lip at bottom)
~ '.i.J raESS
1"1-+7(, S#11.oy 86~ 7JU-.
LEGAL D~ nON (oftice use oo1y)
LOT BLOCK
ADDmON
OWNEll
(Name)
(Address)
(Adcbess)
APPLIC~ _ . I
(Name) /2Qf'f Nf A (L.. ei.M1/11::J I N<!!J
(Address) /7()72.. Ieevel!.6 WAV
(Adcbess) ,
(Contact Person) ~S F; / 11' k:E
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rJLJJI"""'.i,~~IAlIIIJl
1. 0.- File
2. Yellow City
3. Gold Applicant
PERMIT NO'/()/lfO/43\
ZONING (ofJioe use)
PID
(Phone)
(City)
(Zip Code)
(phone)
'p, L.
(City)
(phone)
"..~
#7. 3884-
5S37z..
(Zip Cole)
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Size of water service inches.
Location of any couplings from structure feet.
Type of sewer pipe. 0 ABC 0 pvc 0 Cast Iron
Estimated lcmgth of sewer line feet.
Clean out (ifrequired) located at _ feet from structure.
rJ!.1!i S~DULE
Residential sewer and water line connection SS1.SO 1ndus1ria1, Com'1 & Multi-family 1% of job cost with a SS1.S0 minimum
Sewer connection only $25.50 Water connection only $25.50
Estimated Cost $ Building Pennit #
SEWER AND WA1.r..K PERMIT l'~
STATE SURCHARGE
TOTAL PEJtMI'iI' FEE
(0IIce Vie 0IIIy)
TIdI AppIeatiGe BeeeIIles Y........~ ............'........
II8IIdIIII 0IIIdaI
..
$ +9. So
$ w .50
$ 5l.J_W
Paid SO _ W
Date :3 -' ~"I 0
tN4O.!!J9t!Ol
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U IaoIIr __........, rc... (B)<U7..-o,ru (951) ....7-4245
.....1Wmta sa.t s.&,....... .....I~ T.... 55372
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