HomeMy WebLinkAboutS/W Permit #00-0211
DATE TIME
CITY OF PRIOR LAKE
IN.SPECTION NOTICE
SCHEDULED
4~
P'
2-: 3...0.
ADDRESS
52'71
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o PLUMBING RI ~IV\UI"ILL~
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
W 0 SEWER HOOKUP A..... (t) 0 FIREPLACE FINAL
\JY ~ PLUMBING FINAL~ ~ (jrGAjJ:' AIR TST
o MECH FINAL l./:!:iJ L" . 0
.J.h~~ ~ :p,.". "l...- ~
/40f7f
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:(/)
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o WORK SATISFACTORY, PROCEED ....-- . - ~
~ CORRECHCTlON ANO PROCEED tYfv 1<, ~ 0 =---
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: {'2.....-., Owner/Contr: rv
~-r r
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTI
~~~
~NE~
GREEN . FILE
YELLOW - APPLICANT
GOLD - CIT'f
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
S.w. No. {)?J ,02,11
NOTE:
Sewer and Water
contractors must
be registered
with the City.
APPLICANT: d..:r: S;~V; ("'P..$
ADDRESS: ~ytf"6 $"U*,("./.>' 41/~ /~I /It"" DArE:
SIGNATURE: ~ f2~
SIWE ADDRESS: S~ 99 /VdJ sf" Q. e
-ptfONE: ~/.:l- y~(-:?~ /
~ /.;2 - Gl~
BLDG. PERMIT # (J7) .,(J 2-1 (
PID#-ZZ:;-O~~ -OOz,-O
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
------------------------------------------------------------------
------------------------------------------------------------------
BY
your permit when approved. / /
DATE: 4//?,/(JO
/ /
This
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FEES:
$
$
$
35.00
.50
35.50
Sewer and
Surcharge
TOTAL
* Fee for either sewer or water individually is $)V.~
$ .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.
RECEIPT #
REC'D BY
/YcnJ
iJ/A--
/
DATE PAID
cf';;~rV
i7/rr/
AMOUNT PAID
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230/ FAX (612) 447-4245
An Equal Opportunity Employer