HomeMy WebLinkAboutS/W Permit 94-0078 _ � DATE TIME
CITY OF PRIOR LAKE CALLED-IN
INSPECTION NOTICE SCHEDULED �' �
PERMIT NO. �� - �' / 8 COMPLETED
ADDRESS � ��Z.Sg �� � .
OWNER CONTR.
� TELEPHONE NO.
tL � FOOTING ❑PLUMBIN(3 RI OSITE INSPECTION
� p FRAMING ❑ MECHANICAL ❑ EXCAV./GFlADING/FILLING
y❑ INSULATION �B'YVATER HOOKUP O LAKESHORE/WETLANDS
� O WALL BD. ❑ METEA SET/TURN ON ❑ COMPLAINT
2 ❑ FINAL -B-3EWER HOOKUP ❑ FOLLOW-UP
Q❑ FOUNDATION ❑ SEPTIC INSTALL. ❑ SEPTIC FINAL
_ ❑ DEMOL. ❑ SEPTIC MAINT. ❑ FIREPLACE
J O FIRE PREV. ❑ PLUMBIN(3 FINAL p
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WORK SATISFACTORY:PROCEED ❑ PHOTO TAKEN
�❑ CORRECT WORK AND PROCEED
�❑ CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
V O CORRECT UNSAFE CONDITION WITHIN HOURS. INSPECTOR WILL RETURN.
❑ STOP ORDER POSTED. CALI INSPECTOR.
O INSPECTION REOUIRED. CALL TO ARRANGE ACCESS.
call for the next inspection 24 hours in advance.
Owner/Contr. ite
Inspector � 447-4230
YelbwCopy/SRSNo � NTits Copy/Map�ctor'aFds
G> OREEM - FILE
Or P � l OA YEIIOw - APPLICANT
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CITY OF PRIOR LAKE NO. y�
M�n'NES��P SEWER AND WATER PERMIT
NOTE: Sewer and Water
contractors must
be registered
with the City.
�
APPLI CANT : � PHONE : _�L�.�7 ��� � �
��
ADDRESS• �� DATE: �
SIGNATURE:, / BLDG. PERMIT # "'—' �
SITE ADDRESS: �Y-iZS7 T PID# ��'�7T – D�b'O
FILL IN THE B:LANKS .
1. Estimated length of water servic�� �� feet.
2. Size of water service inrh(es).
3. Location of any couplings from s�tructure���eet.
4. Type of sewer pipe. ABS PVC�� Cast Iron
5. Estimated length of sewer line��feet.
6. Clean out (if required) , loc��ted at ��1� feet from rf���
structure.
' This application becomes your permit when approved.
BY DATE : h �,(3/ Q�
FEES: $ 35.00 Sewer and wat:er line connection permit.
$ .50 Surcharge
$ 35.50 TOTAL
* Fee for either sewer or water iridividually is $20.00 plus
$ .50 surcharge.
* Sewer and water permits issued far new construction must be
recorded on the building permit card at the time of issuance
to insure that no duplicate sew�er and water permits are
issued.
DATE PAID .�� AMOUNT PAID 3�- �
.
RECEIPT # � ��, REC' D BY �,,�
4629 Dakota St. S.E., Prior Lake, Minnesota 55372 / Pfi. (612) 447-4230 / Fax (612) 447-4245
AN EQUAL OPPORTUNITY EMPIDYER �