HomeMy WebLinkAboutSewer & Water Permit #14-146 �TE TIME
CITY OF PRIOR LAKE � .�� Z–�
INSPECTION NOTICE SCHEDULED
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ADDRESS `�`� ` � � ��
OWNER CONTR.
PHONE NO. PERMIT NO \ '
❑ FOOTING D PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPWCE RI
❑ INSULATION �SEWER HOOKUP ❑ FIREPLACE FINAL
❑ FINAL ❑ PLUMBING FINAL ❑ GASLINE AIR TST
O SITE INSPECTION 0 MECH FINAL
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�WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WO , ALL FOR REINSPECTION BEFORE COVERING
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Inspector: Owner/Con� �
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CALL 447-9850 FOR THE NEXT INSP N 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE F03'c YO(1R PERSONAL HEALTH & SAFETY!
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� � rRlp�� Date Rec'd
� �. CITY OF PRIOR LAKE � .�, ` � �
� � SEWER AND WATER PERMIT 7
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�. �e� File pERMIT NO. �
2. Yellow City
3. Gold Applicant •
ease or ' t and si at bottom
ZONING (office use)
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LEGAL DESCRIPTION (oflt'ice use only)
LOT BLOCK ADDITION PID
OWNER
(Name) (Phone)
(Address)
(Address) (City) (Zip Code)
APPLICANT
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(Address) (City) (Zip Code)
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APPLICANT PLEASE COMPLETE BELOW
Size of water service inches.
Location of any couplings from structure feet.
Type of sewer pipe. ❑ ABC ��C ❑ Cast Iron
Estimated length of sewer line feet.
Clean out (if required) located at feet from structure.
FEE SCHEDULE
Residential sewer and water line connection $51.50 Industrial, Com'1 & Multi-family 1% of job cost with a$51.50 minimum
Sewer connection only $25.50 Water connection only $25.50
Estimated Cost $ Building Permit # - ,,
SEWER AND WATER PERMIT FEE $ Z S c �� �
STATE SURCHARGE $ � _ 64%
TOTAL PERMIT FEE $ � � � .s?J
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid� O S � Rec t No. �O,�y /�
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Date .� B .
Buildins Official Date ' ' �'
24 6our notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street 5.E., Prior Lake, Minnesota 55372