HomeMy WebLinkAboutPlumbing 03-1069
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS 2..~SC::; J<,.. hcr~ l~
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:
.t.
I,'t;- ~y
(')),v i-Y
DATE TIME
1- n'Of' 0; CC
-, - /6 &>9
o EXIGRADlFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST~
rr( '- ---.AI ">'" .
,
XWORKSATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT~ALL FOR REINSPECTION BEFORE COVERING
Inspector: !)/ 1/ Owner/Contr:
CALL -v'7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
msNOT,
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT ~'^
~tf Q(\
1- Blue File I PERMIT NO 'Z tJ1
2. Gold C;,y 't:/ ~ - I/'.
J. Yellow Applicant ,U
(Please'!'ype or print and sign at bottom)
ADDRESS
;)q~S- MU+<:::J/V
ZONING (office use)
Ie}
APPLICANT PLEASE 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)
LEGAL DESCRIPTION (office use only)
LOT JifaLOCK 3 ADDITION /tIdftb ~_
OWNER
(Name)
~U-kOD~ a~~1.
(Address)
APPLICANT L (J I
(Name) eoV\. OwO-+ 1'11:
+L. v
(Address) :J 0 R - 1"7 - 1111 <- ,;J
(Address)
(Contact Person) d0 A--k. J) J 0 A d / /1 /J
"PLICANT SIGNATURE 1;It4f 15~
Quantity
FEE SCHEDULE
Industrial, Commercial & Multi-family 1 % of job cost with a $39.50 minimum
Estimated Cost $ ~ 0
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
JOflice Use Only)
'his Application Becomes Your Building Permit When Approved
Building Official
Date
(Phone)
PID;?s- 3J;;.,0&&'-0
'1 ttl- l.N~D
(phone)
/-(:'t/<:,:~ r
(City)
"tJ]-5IeJ~
(Phone)
r;~]'f1
(Zip Code)
q. /tJ... ~I '{j'fl/
sin/Oj
DATE
Type of Fixture
I
\
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backtlow Assembly
Backtlow Assembly Test
Lawn Sprinkler
Other
Residential, New One & Two.Farnily
Residential, Additions & Alterations
$99.50
$39.50
Building Permit #
59.S-0
.50
,-/0--
I Paid L(O. -
I DateX_I?~
ReceiP~53/ to
By C1
o
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714