HomeMy WebLinkAboutPlumbing 03-1223
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CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
SCHEDULED
5lJ Y c) (lov.cI S t' ch...___
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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DATE nME
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o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
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~ SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W7RK~ALL FO~ REINSPECTlON BEFORE COVERING
Inspector: VWI q-fS & Owner/Contr:
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CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH 4 SAFETY!
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Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
Cf IS-. O.?
:ase '!ype or print and sign at bottom)
ADDRESS
I. Blue File I PERMIT NO I
'Gold Ci,y . Af_/7 77
., Yellow Applicant V. vCc.J
(Phone) (67) C;I<~ 1':t5J
5.Y{) It
(City) (Zip Code)
(Phone) (7/7) C//3- /3'f{3
9- / 5~d::J
504-0
PONOS EOtfi6
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
(Phone)
(Address)
~YJiANT;;f)e(..ovurK:s IV\.c
(Address) b<;:J,() Uo i ~ Ik Or
(Address)
(Contact Person) <,}e JC- J: &- rk
APPLICANT SIm:ATURE ~n ~- d
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DATE
Quantity
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)
ZONING (offie< u,,)
PID 2~.. ?tJCf.a7-o
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backtlow Assembly
Backtlow Assembly Test
Lawn Sprinkler
Other
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FEE SCHEDULE
Industrial, Commercial & Multi-family 1 % of job cost with a $39.50 minimum
Residential, New One & Two~Family $99.50
Residential, Additions & Alterations $39.50
Building Pennit # tJ J - / z. z.-7
J q, )7J
_.50
"71/. {)lj
Estimated Cost $
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
(Office Use Only)
I This Application Becomes Your Building Permit When Approved
I Paid Fa (/l)
I Datrj, /.>. () J
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
Receipt ff5Z 91
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