HomeMy WebLinkAboutSprinkler Permit 04-1101
DATE TIME
CITY OF PRIOR LAKE I~rf
INSPECTION NOTICE SCHEDULED
ADDRESS /4llo0 -~~ Q,. r-
~
OWNER CONTR.
PHONE NO. PERMIT NO. L! - IIO(
o FOOTING o PLUMBING RI o EXIGRADIFILLlNG
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL , GASLINE AIR ~
o SITE INSPECTION o MECH FINAL L..~ ~t, <-
COMMENTS:
.4 WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~KtL FOR REINSPECTION BEFORE COVERING
Inspector: ' ~ Owner/Contr:
CALL 44285 OR TYE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUlREMENJ ARE FOR YOUR PERSONAL HEALTH &I SAFETYI
lNSNOTl
G)
~_..V
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
10. 1,,5.04--
~. ~~ ~:~y PERMIT NO. () ~-" lID I
3. Yellow Applicant 6f'
\.t'lease type or print and sign at bottom)
ADDRESS ZONING (office use)
J Lj / bO 6adg-o-r Ci r. N. N
LEGAL DESCRIPTION (office use only)
LOT L/ BLOCK J/ ADDITION W~ j()C/2.i.J- PIDZ,J.4o+". oH. 6
, ,
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compa.ltuent sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
OWNER '7 +
(Name) -./' 1t:J,N\ I I e\.O
I (Address) J~Jb~ ~CJ". #.1\.1.
APPLICANT~ ,_ I \ ~ \
(Name) ~ rb ~ r-\\AAM,1O~~
(Address) 2~()S c;,A-r'~../oI #jL. ~d'.
(Address)
(Contact Person) A-m.J,-y- p_1
APPLICANT SIGNATURE
Quantity
FEE SCHEDULE
Industrial, Commercial & Multi-family 1 % of job cost with a $39.50 minimum
Estimated Cost $
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
(Phone) L'S'2) 233 - //)'3
(Phone) J '/~L.a2 7 - tlt).3 3
J41fl ~ S-1!i"V~,
(City) (Zip Code)
(Phone) -L(,IZW7-1'I31
DATE /I)/~r/iy
Type of Fixture
!
Rough- ins
I Water Heater
I Water Softner
I Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
111 s-bJl It:,.c./(FI-'W PVJ3 ~ /~~.
Spr~K\~.
Residential, New One & Two.Family $99.50
Residential, Additions & Alterations $39.50
Building Permit #
~~II()I
3q · S1)
.50
I/f). d/)
Paid ~ tI (fl)
Date /1. )S. d~
Receipt No. f!':l11
By I_
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714