HomeMy WebLinkAboutPlumbing 03-1254
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/5'1 57'
Jp[~,\~ Q~~
- - ~ --
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
DATE TIME
q-z~
:<-/25'1
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RJ
o FIREPLACE FINAL
o GASLINE AIR,.:{ST .
)if l............. ~
~ SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT K, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
, Owner/Contr:
o FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
EQUJREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
IlaNOn
.----...-.-...-.......,--."-
--..-.--..----.-."---..-.-.---.... ...,-_._--~,-
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
(Please lYj1e or print and siJm at bottom)
I ADDRESS 15\6QJe-+-ft.v5
1- Blue File I PERMIT NO 'II
2, Gold Ci<y ',/12 _ 1'5'
J. Yellow Applicant VJ {C7\......
ZONING (offk, 0")
\bss / {{Q%~ '?
I
~O,
LEGAL DESCRIPTION (office use only)
LOT(3LOCK ,:::\. ADDITION(~
l/ UV
OWNER ~ ()
(Name) " YD'l r vCSS \e.v
(Contact Person) D~ (Phone) 8)....w\..J
'PLICANT SIGNATURE 'D ~X- DATE 9: - f (., - 03
APPLICANT PLE~ilE 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)
(Address)
APPLICANT
(Name)
(Address)
Quantity
~lWU
{)tJI\..k\AJ) wede\{
~ L 14 ,~@- Atre 6\.,-'
(Address)
FEE SCHEDULE
Industrial, Commercial & Multi-family 1 % of job cost with a $39.50 minimum
Estimated Cost $
39.5D
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
_{Office Use Only)
'his Application Becomes Your Building Permit When Approved
Building Official
Date
PID ..:;, ~315' - (')j-d
(Phone) q~;;l.;>lo '3103
(Phone) to l;:)~ g{) \ . l~l.o.()
'\il rtc..kuAl\C!VI. ,"l5.?,5:5
(City) (Zip Code)
Type of Fixture
\
Rough,ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
Residential, New One & Two-Family $99.50
Residential. Additions & Alterations $39.50
~.6b
.50
L.ID. Of> '
I Paid IJD-'--
I Date q-/'7 -'3
Recet?3&5""
By 0-----.
v "
24 hour notice for all inspections (952) 447-9850, fax (952) 447,4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
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