HomeMy WebLinkAboutPlumbing 03-1179
DATE nME
CITY OF PRIOR LAKE tOJJ?-d)>
INSPECTION NOTICE SCHEDULED
ADDRESS ~q Ca.JssCt '" d-. S'r
OWNER CONTR.
PHONE NO. PERMIT NO. 3- (t?1
a FOOTING o PLUMBING RI o EXIGRADIFILLlNG
o FOUNDATION o MECH RI o COMPLAINT
a FRAMING o WATER HOOKUP o FIREPLACE RI
a INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL o GASLINE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS: ~<pr,~h",-
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~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~R~. jft')L FOR REINSPECTION BEFORE COVERING
Inspector: VJj:f' Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSNon
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
f. +. OJ'
I. Blue File I PERMIT NO I
2 Gold City . /) ;7-1.'/. ?::1
3. Yellow Applicant CL.:> . , I
(Please type or print and sign at bottom)
ADDRESS
5809
Cvos~\.Q
5~+
ZONING (ofticeuse)
LOT
LEGAL DESCRIPTION (office use only)
PID
OWNER
(Name)
(Address)
APPLICANT
(Name)
(Address)
Quantity
BLOCK
ADDITION
5-\e.. Dt BvooVV\
~
(Phone) ClOd -~(o""q~Cb
(Phone) lo\d - 80\ ~ 5d lo D
\-\'^--k~\ ~~ 653fXJ
(City) (Zip Code)
(Phone)
'S~
t A },A-
- - .--
\.J
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)
DATE. 9 - 1- - D 3
Type of Fixture
\
Rough-ins
Water Heater
Water Softner
I Stand Pipe (Washing Machine)
I Sewage Ejector
I Backflow Assembly
I 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 $
\ lDD~O
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
69 .00
.50
1.(0, otl
(Office Use Only)
~1 This Application Becomes Your Building Permit When Approved
l
Building Official
Date
Paid I'tJ. 0 0
Date9. t"". () J
Recei~~. Z 7 r
By I_
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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