HomeMy WebLinkAboutPlumbing 03-1028
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
JLf4 "y
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED 101 ')e>/D 3
~Rr).
CONTR.
PERMIT NO.
~ - Ld2-'A
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~-
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
Owner/Contr:
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
Date Rec' d
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File I PERMIT NO. () 3 -I a ~
2. Gold City
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS l4-q 1-L'
r1lOJlLtOLt Rd. Ne.
ZONING (office use)
(GIS()
LEGAL DESCRIPTION (office use only)
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(f/m.1&r, Kj I=>
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1:r;::'~fANT N(J/lJl OYY/ PL.{UYl blnq(PhOnel [(.1f2YD~ 7 -403:;
(Address) ttqOS tJarfl'Ua /lY!SO. m.ol s. W-IOf
(Address) (City) , (Zip Code)
(Contact Person) .ArYl () rrr P ~ (Phone) ({f I~) g~ 7---4 D??;;
"PLICANTSIGNATURE ~;JfJ~ ~ DATE f /;31 D3
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture I Quantity
Bath Tub with or without shower I
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
I Shower Stall
I Sinks
I Bar Sink
I Water Closet (Toilet)
LOT
BLOCK
ADDITION
PIDa5J f(dl,-()d^-3"D
OWNER
(Name)
(Phone)
(%2) 4Lj7'<i~?7
(Address)
Quantity
Type of Fixture
Industrial, Commercial & Multi-family 1% of job cost with a $39,50 minimum
Rough-ins
~ -Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
. ~ Lawn Sprinkler
Other
FEESCHEDULE LnSiaAUc( tJ~ff!l;(~
Residential, New One & Two-Family $99,50
Residential, Additions & Alterations $39,50
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
\?:R. f:i2
.50
l-I-n. a2
.
(Office Use Only)
"his Application Becomes Your Building Permit When Approved
Building Official
Date
Paid l.{ O. --
Date~/5_3
Receipt NO.Cj 1/K9 J-....-
BY~
U
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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