HomeMy WebLinkAboutPlumbing 03-1281
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
/o-lt1~
ADDRESS
. ~402 fkr&j,.1 (VJ;
OWNER
CONTR.
PHONE NO.
PERMIT NO.
"3-/lj-/
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
o EXIGRAD/FILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
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"ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~~'),~FOR REINSPECTION BEFORE COVERING
Inspector: Ii V r Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
/NSNOTI
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PEAAl..ll
C/. 22_ 03
I. Blue File PERMIT NO I
2. Gold City "03 -/" a I
J, Yellow Applicam CA/
(Please tvDe orDrint and sil!;ll at:. .w._)
ADDRESS ZONING (office use)
6'/{):{ iJeerF7-JrJ !!/r K- 2-
LEGAL DESCR.I1" uON (office use only)
LOT BLOCK
ADDITION
Pill 2S 4<JO. CO2 - 0
OWNER ~
(Name) ~rCl() h rJ ().:^-9 h
(Address) 5'1 D ~ IJec.y PI e./ d r71 ,~
(Phone)
!r/(),r }Q)G
L/I/O- 999'3
;11/7 5537':2..
APPLICANiJ - !Ii
(Name) ralY/ 0
(Address) ;;< '-1/ If 9
P JUYhh)~ q
, ~
(Phone)
I a...-l-e II /~I /~
(City)
.M 2,h~/~W A UC:
(Ad ess)
(Contact Person) _ ',~ -e... Y\ Vl v{
f:k/JU~~
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APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower --
Dishwasher
I Floor Drain
I Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
(Phone)
95;)- '1hCf- (P99 <j
/?1~ SSOY"Y'
(Zip Code)
9Sd - 4h1- ~99 <j'
9'- /7-03
1?PLlCANT SIGNATURE
DATE
Quantity
T:ype of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage ~jector
Backflow' Assemblv
Backllow Assembly Test
Lawn Sprinkler
Other '
FEES'--.rt.l!.DULE
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 $
Building Pennit # 05 -/ Z ~ /
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
,'79. SO
.50
40, 00
(Office Use Only)
This APmF. omes Your Building Permit When Approved
. q. z,~ ,03
UII ng Official Date
Paid ~O ~(}()
Da~. z,z,.,(ts
Rece~~dfo, 1-'
By
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U
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245