HomeMy WebLinkAboutPlumbing Permit 03-1309
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
I~ 141-
f5r CNt~ Lt.J.. -rr - /
OWNER
CONTR.
PHONE NO.
PERMIT NO.
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
DATE nilE
I () - '--t1'J
3-135f
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
If 1-0
'lt~f1rr
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~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspedor: ~ f Ot-6 Owner/Contr:
CALL "7-9850 FOR THE NEXT INSPECTION 24 HOURS IN AOVANCE.
'/aNOn
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
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Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
q. 20.03
l, Bille File I PERMIT NO I
2 Gold Ci<, . ().'13 -13 /la.
3, Yellow Applicant V7
(Please!yp~ or print and sign at bottom)
ADDRESS
}U14d \~J'1itUJ
ZONING (office use)
LOT
LEGAL DESCRIPTION (office use only)
BLOCK
ADDITION
PID
OWNER , C. _ _
(Name)'0.n hYl '-- ~ll/I/S01.m{
(Address) /. (~- IJ-~ tWOV-t ')
I,;UL.L.lliAN YVA,j t:n (,VI<ID"lIIIJI..i"u
6030 CULLIGAN WAY
MINNETONKA, MN oo;J40
(952\ 933-7200
(Address)
(Contact Person) Ari?11W
"PLICANT SIG~ATURE-/Y)l1:iYUU ;()ttVf41/)
APPLICANT
(Name)
(Address)
Quantity
(Phone) t10-;r tj!d.O - ~
(Phone)
(Ciry)
(Zip Code)
q5J-- q IJ -7;;7tJ
DATE C11 loll ()?;7
(Phone)
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture I Quantity I Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (I or 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) I Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost witb a $39,50 minimum
Residential, New One & Two-Family $99.50
Residential. Additions & Alterations $39.50
DO
Estimated Cost $~I"A'? -
Building Penn it #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
\..3Q . ~O
,50
4'U. tJO
(Office Use Only)
-his Application Becomes Your Building Permit When Approved
Building Official
Date
I pai~OO
I Datl? 2(,.O;J
Receipt 4rt. ~
By ~
/
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-t714
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