HomeMy WebLinkAboutPlumbing 03-1274
DATE nME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS I c;<., t{ 1
'fLrrY C\.f
OWNER
CONTR.
PHONE NO.
PERMIT NO.
"?-J77f(
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
}i(o GASLlNE AIR~TST
1-. <;'.
- 1
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
COMMENTS:
/'
rRK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECfEi' CALL FOR REINSPECTlON BEFORE COVERING
Inspector: Owner/Contr:
CAL~ 7.JSSoftR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQ~EMENTS ARE FOR YOUR PERSONAL HEALTH .{ SAFETY!
INSNOn
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
; ~~: ~::y I PERMIT NO'1J3-/~'7I7LII
3. Yellow Applicallt 1C7"{ I
(Please!YEe or print and sign at bottom)
I AD~S~S
1-/ 1 Ao~c.,+ C; r
ZONING (office use)
LEGAL DESCRIPTION (office use ooly)
LOT hOCK / ADDITION / Jj,tf~ ~
PIo$~td- &S-io
OWNER
(Name) (): "": h',
1~:^'71..,)
(-t',hr...\- (,"
(Phone) 9<J..~nr' i.>1.;"
(Address) j':l.':l.'" 1
APPLICANT
(Name) ,3(,.t:,
<;:; ~Q
~l.P.I> -4 1-11' 17
(Phone) -=u:;,J -!i'q".. '/ c'DC
(Address) J,jl/i.<l :2.'~ r-,^ <t.J"-
(Address)
-<;'~fl
(Cit?'
.,..(~,~
(Zip Code)
(Contact Person) n,,,~
'PLICANT SIGNATURE 'D1,. ,g....."
(Phone)
Cl.1.l - ,f(G4 .. 1 l.DO
DATE q .1<.."."
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
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler PilI!. n., I"
I Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
Residential, New One & Two-Family $99.50
Residential. Additions & Alterations $39.50
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $ ~'l ._",,0
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $ i/o. CO"
__.JOffice Use Only)
'his Application Becomes Your Building Permit When Approved
Building Official
Date
I Paid Ift),---
I Datq_ /1- ~
Recltif~ --;;}-
By/,;,
,j~
()
24 hour notiee for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
_._~.~-_._-,.,.__...._.._,._-