HomeMy WebLinkAboutPlumbing 03-1130
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
\S;oc::;-()
_ \D r.c. 1'<;
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
COMMENTS:
DATE TIME
Cj-::2;::),-o3 ~PM..
Ch<;l.<:;'
,
_< - U-r.. 1\
o EXIGRADfFlLLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
,& GASLlNE AI~. r I,
^ l .w'^ ~
ok. t.... (" lo<:,.r .u^'\:. ~!l '1
X WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRE~CR ALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CALL' 0 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CO~IREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
tNSNOTJ
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~- -
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
l. BIlle file lPERMIT NO '2 ~
2, Gold Ci<, . 0 J - 1.'(3
3. Yellow Applicant It
()'Iease me or print and silm at bottom)
ADDRESS
/50$0 t/.e/rC.6e'.f
/'.45 f
LEGAL DESCRIPTION (office use only)
LOT I BLOCK 3 ADDITION ~fVA A1 &elk.
i/ vv
OWNER
(Name)
.mM
tJ~H,qv.s
. (Phone)
rK'/o.e L/iM
(Address)
/6050 J~.M?.r f'/#&'f
APPLICANT ,
(Name) 'c/.I):;&&f/()~ /.?8.t t5 /1/'6
(Address) /..lY6~ Z/pA?/!A/ ,4//,e
(Address)
C/p-,ec.
_APPLICANT SIGNATU~E ~ ??? i~
ZONING (otlkeu,e)
I
PID ,;)5- 39S- oslo
6Ht4V6'-6
(City)
9~ - 4'1o/'-7~CJC>
5S3?.?
(Zip Code)
(Phone)
(Contact Person)
(Phone)
DATE
I Quantity
I
I
I
I
I
I
I
I
APPLICANT PLEASE COMPLETE BELOW
I Type of Fixture Quantity I Typ
I Bath Tub with or without shower I Rough-ins
I Dishwasher . . Water Heater
I Floor Drain Water Softner
I Lavatory (Bathroom Sink) Stand Pipe (Was
I Laundry Tray (I or 2 compartment sink Sewage Ejector
1_ Shower Stall Backflow Assem
I Sinks Backflow Assem
Bar Sink _1 Lawn Sprinkler
I Water Closet (Toilet) Other
FEE SCHEDULE
Industrial, Commercial & Multi-family I % of job cost with a $39.50 minimum
,]>/.;;//03
e of Fixture
l
j
J
J
hing Machine)
bly
bly Test
Residential, New One & Two-Family $99.50,
Residential, Additions & Alterations ~
Building Penn it #
Estimated Cost $
(Office Use Only)
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.50
---!
This Application Becomes Your Building Permit When Approved
I Paid....., ,:) .c;-
<:..:5 7~.J D
I Date R ';?-s- :3
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
ReCeiW!33(..
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