HomeMy WebLinkAboutPlumbing 03-1126
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED Q f3Cf -3
1~6tt/ ~p
CONTR.
PERMIT NO. (J6 - /1.).- ~
ADDRESS
OWNER
PHONE NO.
COMMENTS:
o PLUMBING RI 0 EXlGRADIFILLlNG
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GAS LINE AIR TST
o MECH FINAL 0
SI) n'/u !rile V-
I
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
()t
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
:s::~:EC.L FOR REINS~::::::::FORE COVERING
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
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AUG-2121-21211213 13:3121
CITY OF PRIOR LAKE
9524474245
P.I2I1/12I1
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
P 4- f-l1
U::ld~':' I PERMITNO'O.3-/I-::L} I
:I. Yellow Appliault I C/ t2 '
\ I ZONING (of&t.:use) \
(Pl.... type or print ...d.iJn at OOllll~
I ADDRESS
(50(oL{ U BS 5,
LEGAL DESCRIPTION (016a! use only)
LOT ~ BLOCK 3 ADDITION
4~
PIrV25- 3tls-OSL(
IOWNBR
(Name)
(Address)
(phone)
PPLICANT SIGNATURE
USI. ;')65 - ~(jl&:J
Mill S5Ic\6
(Zip Code)
(Phone) LP S I <'\ {.p <:-,- - &t18U
DATE 1; -JQ -63
(Address)
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
.Floor Drain Water Sofbter
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (l or Z compartment sink Sewage Ejector
Shower Stall Backf10w Assembly
Sinks Backflow Assembly Test
Bar Sink I Lawn Sprinkler
Water Closet (Toilet) Other
PLEASE COMPLETE BELOW
FEE SCHEDULE
Industrial, Commercial &. Multi-family 1% of job OOSI with a 539.50 minimum Residential. New On. &. Two-Family 599.50
ReSid.ntial, Additions &. Alt.rations 539.50
Estimated Cost $ -150' uJ
Building Permit #
BIIBdllIC omd.'
D...
:sq.5U
.50
t.1D.(lf)
Paid //6--
Date fhJ5-3
By
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.-lOmel: U"e ODly)
Ibis Application Bec:omes Your Building Permit When Approved
Z4 /lour noti.. for all inspections (951) 447-9850, fax (951) 447-4245
16Z00 Eagle Creek A Co S E P'
~ , . ., ..or Lake, MN 55372-17U
-
TOTAL P.I2I1
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