HomeMy WebLinkAboutUtility Permit #00-0710
DATE
CITY OF PRIOR LAKE 'J L
INSPECTION NOTICE SCHEDULED ~II~ /-V
ADDRESS .lfo 1.1 if "5 ~ l V.~ ~-L
TIME
~~:CX)
CONTR.
OWNER
fl'r() - (")~ l C
PERMIT NO.
PHONE NO.
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
o PLUMBING RI
'^ 0 MECH RI
~~O WATER HOOKUP
SEWER HOOKUP
o LUMBING FINAL
o MECH FINAL
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COM!\IIENTS:
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"2 t\-O( c.. _ O.
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LRX~WTOR~' :ROC D-
O CORREC ,~~1 .".; ,.'"", EED
o CORRE ORK, C L~ ;~;~EINSPECTION BEFORE COVERING
Inspector / Owner/Contr:
THE NEXT INSPECTION 24 HOURS IN ADVANCE.
TS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
lNSNOTJ
GREEN - FILE
YELLOW . APPLICANT
GOLD . CITY
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
S.w. No. 00- 01 to
NOTE: Sewer and Water
contractors must
be registered
(A\~~ J: t4j b:vU with the City.
APPLICANT: J't'\ \ 0.1\' ""':ch::I :PI U~ ~ ~'ONE: qs.:;) - 44, '1- 4'14 'I
ADDRESS: I Lf~ tAJyJ- (Sr-cJ. ~ DATE: _ g I iU((]l)
,'. /J ~~ mN <:;:;...)3/'1 f ~l{
*" SIGNATURE:0~~q~..5"~ BLDG. PERMIT # em-OlIO
SITE ADDRESS: \&41 ~ Du lu'~ k PID# 6?("')- C'[O~-68"~-D
FILL IN THE BLANKS
1. Estimated length of water service
feet.
2. Size of water service
inch(es) .
3. Location of any couplings from structure
feet.
4. Type of sewer pipe. ABS
PVC
Cast Iron
5. Estimated length of sewer line
feet.
6. Clean out (if required), located at
structure.
feet
from
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This;ap~lication b~~S your p~ when approved.
BY~ ~ 1 l1ArluJr.~DATE: ~jE/tm
==tJ==.==============I=============================================
FE: $ 35.00 Sewer and water line connection permit.
$ .50 Surcharge
$ 35.50 TOTAL
*
Fee for either sewer or water individually is $J7.~ plus
$ .50 surcharge.
* Sewer and water permits issued for new construction must be
recorded on the building permit card at the time of issuance
to insure that no duplicate sewer and water permits are
issued.
DATE PAID CZ5 J I'-{ / cJ[1
,
RECEIPT # .:!:> X dlJ.5
AMOUNT PAID I,<is'~ 00
REC'D BY f Jc1....J
G
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230/ FAX (612) 447-4245
An Equal Opportunity Employer
Quantity
CITY OF PRIOR LAKE i'7: ~~~, ~~licant
PLU!/NG PERMIT #
APPlicant:I11;""".s.k .....~....7 ~ jJ.. fm:t, :nv::.. Phone:.9"...c~. ~- Wtft-/
Address: It-f ~o WI -;? Ild A ve..-, ~. €I 4:J1L. t..,..... -S 77"
Signature: ~/.:(/ ~--vL . /
Legal Description: . Lo~ Block ~b
SiteAddress:~.3 DvJIJ~ tJw AlL
Building Permit #
NOTE: This permit will not be processed without co
FIXTURE UNITS
Th. C.nlff of Ih. Lab Counlry
Type of Fixture
Bath Tub with or without shower
Dishwasher
Shower Stall
Sinks
Sewage Ejector
Backflow Assembly (RPZ, Double Check, PVB)
Backflow Assembly Test
Lawn Sprinkler
Other R~y>A)' IL v Rep....~
I"lllk.d..e- ~l?uJQlL HJ~A::l'
~~ ~ fh11\\S ~()u.Yc lIP" 73
CV\vTh Ave-pr<.:OfL. ~1<-L111,,v,u
$
$99.50 $
$39.50 $
$ .50
GRAND TOTAL $
This permit is granted upon the express condition that said
contractor, shall comply in all respects with the ordinances
of the State Plumbing Code and the amendments thereof.
RECEIPT NO. DATE
ATIEST
Call for all inspections 24 hours in advance.
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230 / FAX (612) 447-4245
An Equal Opportunity Employer