HomeMy WebLinkAboutPlumbing 03-1178
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
~.l.-1.
(.J"r{)SS~d- 'l.~ r
CONTR.
OWNER
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:
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DATE TIME
1t)~I2-'Y>
--3-/t?Jr
o EXlGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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~RK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~K. _C~R REINSPECTION BEFORE COVERING
Inspector: /I VV ~ Owner/Contr:
,
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
1NSNon
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH 4 SAFETY!
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
1. +. OJ
I. Blue File PERMIT NO
2. Gold City .tJ..'? _ /'j"71J.
3. Yellow Applicant !..J / J / (,/
(Please tvDe or orint and sign at bottom)
ADDRESS
53&3 C\'o~~ S~~+
t\~ \I\. \ecYv=
LP\4 6@ A\ft-~\
(Address)
{\ti\..YUJ)
,A"PPLICANTSIGNATURE ~-' l ~ DATE
APPLICANT PLE~E 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
BLOCK
ADDITION
OWNER
(Name)
D~ ~ U~'Q3
~
(Address)
APPLICANT
(Name)
(Address)
(Contact Person)
Quantity
ZONING (office use)
PIDZl)'" ~ 11 () 5-+. tJ
(Phone) q5d- 441 - :f1'18'
(Phone) LD \d . <30 \., 6 & lDO
\-\Q~\ \\elJ\-\ 653ft)
(City)
(Zip Code)
(Phone)
~
q."Z..- 03
Type of Fixture
,
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
I Sewage Ejector
Backflow Assembly
Backflow Assembly Test
I Lawn Sprinkler
I Other
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
Estimated Cost $
\ lDOQ(2
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
1 This Application Becomes Your Building Permit When Approved
r
Building Official
Date
Building Permit #
"69.5O
.50
40.06
paid40. () 0
Date~. S-. 03
I
Receipt NO.-t5'Z, 7 t!
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By L
d
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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