HomeMy WebLinkAboutS/W Permit #00-0105
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CITY OF PRIOR LAKE
INSPCTlON NOTICE
. SCHEOULED ~Ep
5315 140TH ~-r:
ADDRESS
TIME
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:::::: 0 PLU::,::NO. C ~~,:~}1fA
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING ~WATER HOOKUP /t 0 FIREPLACE RI
o INSULATION /OS-EWER HOOKUP ~ 0 FIREPLACE FINAL
o FINAL VPLUMBING FIN~ 0 GASLINE AIR TST
o SITE INSPEC.J!Dlf /OMECH F~ 0 --JIIl'z
COMMENTS: / ~ h~
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~ORK SATISFACTORY, PROCEED
o CORRECT ACTI~ tND PROCEED
o CORRECT r:~ , ~ALL FOR REINSPECTION BEFORE COVERING
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Inspector: , \ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
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GREEN - FILE
YELLOW - APPLICANT
GOlD. CIU
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CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
S.W.No.OO - 0/06
NOTE:
Sewer and Water
contractors must
be registered
with the City.
APPLICANT:
17. Jr 5 Rv'. C'" S
PHONE: 95J.- Y~/-3dI?1
DATE: .,5-!?- & 0
BLDG. PERMIT # I 0 ~
PID# 2-5- Dfdn - Of)?' - 0
ADDRESS: r:9/'i/f,i:) /J4.-tJtV/lI~;e~ ~
SIGNATURE:-fl~ (!~
SITE ADDRESS: ,~7:!" AlE. /~tJ rA
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 applicatio our permit when approve~ /
BY .....-- DATE: 3/ ~ / (f()
============~=================================:==~==============
FEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
TOTAL
*
Fee for either sewer or water
$ .50 surcharge.
individually
is
$j?-.5tJ
/750
0-0
.
pI:.:;.:; ...
$/B.oO
*
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.
3/~/OO
3fa9S-8
AMOUNT PAID ~~O
REC'D BY ~
DATE PAID
RECEIPT #
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230 / FAX (612) 447-4245
An Equal Opportunity Employer