HomeMy WebLinkAboutPlumbing 03-1005
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NonCE
SCHEDULED
AJ-,)..q-~
ADDRESS 17!O~ ltVi/d.p_+~<: f_
OWNER CONTR.
PHONE NO. PERMIT NO. >: I tJ()S'
o FOOTING o PLUMBING RI o EXIGRADIFILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL o GASLINE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS: <;t? r(:ltf~
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: << Owner/Contr:.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ
. . .-..-....--1-..----.--- -.-.---......-..
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
i ~~L ~~~licant I PERMIT NO. t)3-ltJOst
q 53- - d:J(P - G,4 t
55 ld
(Phone) to I ;;) - gO I - 6;;)&0
HLl~ 55l3CtJ
(City) (Zip Code)
~ ~ \d~V\J.hD tiavJ.
LEGAL DESCRIPTION (office use only)
/'
LOT I BLOCK 6 ADDITION
OWNER
(Name)
K.ux+ ~.W~d-
~ PVIOV
LoJ6
I
(Phone)
m.U
(Address)
APPLICAN'I1b . ~ D
(Name) _ U\.J'\ 1 n _. ~
-
(Address) ~ 14 3 F\ \..)"t S\.J
(Address)
(Contact Person) D
-opLICANT SIGNATURE ~ \....
ZONING (office use)
PID~ 5"
(Phone)
5CL.MJ
1 wJ4 of)3
DATE
APPLICANT PLEA COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall \ Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
00
Estimated Cost $ _Ill (').-
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
~q .3:)
.50
LID .lU
(Office Use Only)
l'his Application Becomes Your Building Permit When Approved Paid
Date
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
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