HomeMy WebLinkAboutPlg Permit 04-0969
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS ;2849
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
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4 --'(,9
SCHEDULED
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
DATE TIME
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
~ASLlNE AIR TST
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~~K SATISFACTORY, PROCEED
o CORRECT ION AND PROCEED
o CORRE C LL FOR REINSPECTION BEFORE COVERING
Owne rICo ntr:
850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &; SAFETY!
INSNOTl
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec' d
. lease type or print and sign at bottom)
ADDRESS /} ([ 4 c. C
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LEGAL DESCRIPTION (office use only)
LOT IBLOCK dtDDITION fJ) A ~
OWNER
(Name)
_ (Address)
K.r(VLt'S
Q'rJ ()( f/
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~ft
L Blue File PERMIT NO "')
2. Gold City .0/ I -- 0/:.... t:.) r
3. Yellow Applicant L.f /(0
ZONING (office use)
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~:;~~ANT ~ OY l? l ()YYl f L UfYlJ? Ln j
(Address) 1AOS faJl{tiLLtJ M SO.
(Address)
(Contact Person) J bff
APPLICANT SIGNATURE 1/1~
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. L.uent sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
Quantity
PIod5~ l/oL/; OJ-O-O
(Phone) (q 51-)tI Lf3' L/ 0' LP
(Phone) [l.P/~) n" LfD?;?J
t VYt () IS>. B540~
(city) (Zip Code)
(Phone) ~DII~
DATE ct lJQLoLf
Type of Fixture
Rough- ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
I Sewage Ejector
I Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1 % of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOT AL PERl\'u.l FEE $
?A. 50
.50
LfO . t?9.
(Office Use Only)
~
Paid / l/l ~
fU/
Date ,') . L(
Date C,./ ~ tf-(J
24 hour notice for all inspections (952) 447-9850, fa: (952) 44~-4245f
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
Rece~~. L/rl
By
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This Application Becomes Your Building Permit When Approved
Building Official