HomeMy WebLinkAboutPlumbing Permit 03-1181
DATE TIME
CITY OF PRIOR LAKE 10,/74>
INSPECTION NOTICE SCHEDULED
ADDRESS /{,t).t.{ ~n.Y5S'Cw1d-~ C(-
OWNER CONTR.
PHONE NO. PERMIT NO. S - /(~ I
o FOOTING o PLUMBING RI o EXIGRADIFILLlNG
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
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~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~. "FOR REINSPECTION BEFORE COVERING
Inspector: f/ 11 '" Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
9. 4-.0]
I. Blue File
2, Gold City
3 Yellow Applicant
PERMIT NO. CJ3-//9/
(Please type or Print and si211 at bottom)
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
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(Address)
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(Address)
APPLICANT
(Name)
(Address)
(Contact Person)
,-,\PPLlCANT SIGNATURE D
ZONING (office use)
PID zr. ~q'f. 001 (L
(Phone) q ~d~441 -lol13
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(Phone) to \d . 80 \ ~ 5~(O()
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(City) (Zip Code)
(Phone) ~
DATE q - L' 0"3
APPLICANT PLEASE 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
Estimated Cost $
l\to@
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
3'1 JOC>
.50
'-(D. a:l
(Office Use Only)
1 This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid At)
'r .00
Dat~ 5', OJ
Recei~~t 0.2, 7Y.
By
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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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