HomeMy WebLinkAboutPlumbing 03-1305
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS 38tz ~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE nile
SCHEDULED
IO."Z..c:)""~
It tot')
~,~
CONTR.
PERMIT NO.
~
1<: nc;-
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINI;.AIR TST
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~ORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORR(l:EK' CALL FOR REINSPECTION BEFORE COVERING
Inspector Owner/Contr:
CAL v ~ wiso FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
~QUlREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
fNSNOn
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
9. 2ft,. 03
I. Blue File I PERMIT NO I
; ~::~w ~~:li'",' (J? - /?tJS
(Please type or vrint avd sign at bottom)
I ADDRESS
\ 1f37~ N(}{lj PtLKS I7IAJ
J
LEGAL DESCRIPTION (olliee use only)
ZONING (office use)
LOT
BLOCK
ADDITION
PIDtS: ;3&tP. 6V:>. 0
,
OWNER ;.1 h
(Name) I/e Y n JlV II I (r-l n 0 J I'"Y7
(Address) ~ 5tlftX. d ~ tt/oo v1:"" )
::::ULLlGAN WATCn OONDITlormlc
6030 CULLIGAN WAY
"..lINNETONKA, MN 55345
(952) 933-7200
(Address) () (City) (Zip Code)
(Contact Person) ./1(P./ZYJ V (it) V ti1S (Phone) qS;,j-CN? 7::' 7 ()
PPLICANT SIGNATURE C1b ffl}icu /tFhtiJ!MDATE -Z-ld.J-I/J-0
(Phone) Cl<::_A LIt.-; 7 (,:!JdB
APPLICANT
(Name)
(Phone)
(Address)
Quantity
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture I 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
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
cp-
Estimated Cost $.,aF)O Building Permit #
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ l ::sq .50
$ .50
$ --4'0.00
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
I pai'!to. Ci 0
I Dat~.
7. z.t, .0 J
ReceiP~
By
Pd-
/
24 hour notice for all inspections (952) 447.9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372.1714