HomeMy WebLinkAboutPlumbing 03-1358
DATE nilE
CITY OF PRIOR LAKE AM
INSPECTION NOTICE SCHEDULED 10- "-0)
ADDRESS 2EJa:J '&6~.~
OWNER CONTR.
PHONE NO. PERMIT NO. -:> ~~7 IS'l6
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 GASLlNE AIR TST
o SITE INSPECTION o MECH FINAL ~ LANoI_ S,o..i~
,
COMMENTS:
.ftORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORR~ ~ORK. CALL FOR REINSPECTION BEFORE COVERING
InSpector\_ _ Owner/Contr:
CALL\47 50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
UlREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
CODE
I_on
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
/0,7.0;3
1. Blue File I PERMIT NO
2. Gold City ...., "2 -1.? 5.iA
3. Yellow Applicant U-J .....;>' U
(Please type or print and sip at bottom)
ADDRESS 0
.2 8e;7 t50Llt!/7 r
/~L-
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
_PIDz.5: 382-. (JQ. 0
OWNER
(Name)
(Phone)
(Address)
APPLICANT ^
(Name) V,^v l"uA
(Address) ~ g~~
LSvL~/f7
Bo-~ cc. r-';-^I \ I
(Address)
(Phone) q ;-,) - If '13~
Pr/d,r L. L
(City)
(Phone)
18'7/
))"7 7-<
(Zip Code)
(~- .__~.II"~
PPLICANTSIGNATURE ~ /-IA'~-
DATE
/0" 7-05
Quantity
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
I Floor Drain
I Lavatory (Bathroom Sink)
I Laundry Tray (lor 2 compartment sink
I Shower Stall
I Sinks
I Bar Sink
I Water Closet (Toilet)
Type of Fixture
o
[
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
I Backflow Assembly
I Backflow Assembly Test
I Lawn Sprinkler
I Other
FEE SCHEDULE
Industrial, Commercial & Multi-family I % of job cost with a $39,50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Permit # 03 - /.:?Sf:!,;
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
39.50
.50
4-0. () ()
(Office Use Only)
This Application Becomes Your Building Permit When Approved
??~ 10.7,OJ
Building Official Date
pai~. L,.-()
D'~, 7. 1)3
ReceiP~ C. /
By .J:- .
tl
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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