HomeMy WebLinkAbout90-043a .t '
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CITY OF PRIOR LAKE
SEINER AND WATER PERMIT rro. a
NOTE: Sewer and Water
contractors` must
be registered
with the City.
APPLICANT: /T7p J P, I/ PHONE:
ADDRESS: DATE: lyr ^
SIGNATURE: BLDG. PERMIT #
SITE ADDRESS: /���_� PID # - o�`J -0 607- (7
FILL IN THE BLANKS
i
1. Estimated length of water service feet.
2. Size of 'water service_ inch(es). O
3. Location of any couplings from structure feet.
4. Type of sewer pipe. ABS pUC Cast Iron
5. Estimated length of sewer line feet..
6. Clean out (if required), located at feet from {
structure..
This a p]- icat *o b comes your permit when approved. p
B CP at DATE:
FEES: $ 35.00_ Sewer and water line connection permit.
$ .50 Surcharge
$ 35.50 TOTAL
* Fee for either sewer or water individually is $20.00 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 �J� -,� - 9� AMOUNT PAID X 35. S
RECEIPT # 6d REC'`D BY
4629 Dakota St. SE., Prior Lake, Minnesota 55372 l Ph. (612) 447 -4230 1 Fax(612)447-4245-
0
DATE TIME a
CITY OF PRIOR LAKE CALLED-IN
INSPECTION NOT ICE SCHEDULED #
PERMIT NO.. COMPLETE - 3 y
..ODRESS �4 c
OWNER CONTR.
TELEPHONENO.
I j 0 FOOTING ❑PLUMBING RI SHE INSPECTION. '
W ❑.FRAMING ❑MECHANICAL ❑ EXCAV.IGRADINGIRLLING
y ❑.INSULATION ❑ WATER HOOKUP - ❑ LAKESHOREIWETLANDS"
O WALL BD.. ❑ METER SET/TURN ON ❑ COMPLAINT' 2 +e
2 O FINAL D SEWER HOOKUP ❑.FOLLOW -UP
K O:PROGRESS ❑ SEPTIC INSTALL. O SEPTIC FINAL
2 ❑:DEMOL D SEPTIC MAINT. ❑ FIREPLACE
J OFIRE PREY: ❑ PL PING FINAL
C OMMENTS:
Cyr
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h
W
Q -
W -
W
Cr
W.❑ WORK .SATISFACTORY:PROCEED ❑PHOTO TAKEN
O Q CORRECT WORK AN CALL ED
O H- 66RRECT WORK. CALL FOR R REINSPECTlON BEFORE COVERING
0 / ' 0 CORRECT UNSAFE. CONDITION WITHIN H OURS. INSPECTOR "WILL RETURN.
El.STOP ORDER POSTED. CALL INSPECTOR...
❑ INSPECTION .REOUI .CALL TO ARRANGEACCESS. -
call for the next ction - hours in advance.
Owner /Contra si e
Inspector 447 -4230
Y&V wCwyl NOWis N CyPymaGw sRb
O� P RIp�,
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CITY OF PRIOR LAKE
SEWER AND WATER PERMIT No. d -'
}` NOTE: Sewer and Water
contractors must
be registered
/ / /[ wi the City.
APPLICANT: L c:� �i�/ ra l �Ya PHONE
ADDRESS: DATE':
SIGNATURE !,r BLDG. PERMIT #
SITE ADDRE S. - ( ea5r +F 5� PID # .: -602-
FILL IN THE BLANKS
1. Estimated length of water , service ' - feet.
2. Size of water service 3 f �1 inch(es).
3.. Location of any couplirlgp,from. structure c� feet.
t ,
4. Type of sewer pipe. ABS PVC Cast Iron
5. Estimated 'length ' of sewer line feet.
6. Clean out (if required), located at feet from
structure.
This ap ion becomes your permit when approved.
BY DATE:
FEES: $ 35.00 Sewer and 'water line connection permit.
$ .50 Surcharge
$ 35.50 TOTAL
* Fee for either sewer or water individually is $20.00 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 I / —/ `3 —�� AMOUNT PAID Z 0
RECEIPT # _/ RECD BY
4629 Dakota St. S.E., Prior Lake, Minnesota 55372,1 Ph. (612),447.4230 -! Fax (612) 447.4245