HomeMy WebLinkAboutPlumbing Permit 04-0902
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS ~E)~~:2
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
SCHEDULED
DATE TIME
q -'-c:>1
(
~k ~.
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
4 - OUJ~
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
~. GASLlNEA~
j'lo ~,. AA- _ ~
~K SATISFACTORY, PROCEED
o CORRECT TION AND PROCEED
o CORRE W , CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owne rICo ntr:
CALI.1 - ~OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE ~EMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
9. 8., D 4--
..Jlease type or print and sign at bottom)
" ADDRESS
I. Blue File PERMIT NO
2. Gold City .O/L" 0 DO 2-"
3 . Yellow Applicant T 7
/5.332-
E716vb5
E4oG-6
f/W
ZONING (office use)
e/
LEGAL DESCRIPTION (office use only)
LOT.:30BLOCK 3 ADDITION ~ fJ!IC,OS S(}(/-r-J.-I
PID ZS'". 3R;2. tJ8ef. 0
OWNER
(N ame)
LJ~o /f/Cl--J'oA/
(Phone)
?1S-.1178
(Address)
APPLICANT
(N ame)
~o A/C;L..f'oJ
>/9 /Vi 6
(Address)
(Phone)
(Address)
(City)
(Zip Code)
(Contact Person)
(Phone)
APPLICANT SIGNATURE ~ l1er>~
L .
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture I Quantity
Bath Tub with or without shower I
Dishwasher
I Floor Drain
I Lavatory (Bathroom Sink)
I Laundry Tray (lor 2 compa. buent sink
I Shower Stall
I Sinks
I Bar Sink
I Water Closet (Toilet)
DATE
ct ,. r~'-{
Quantity
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
I Backflow Assembly Test
I Lawn Sprinkler
I Other
K
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 # 0 "" '" () 9 () ?
PLUMBING PERMIT FEE $ 39 ~O
STATE SURCHARGE $ ,50
TOTALPEInll.l FEE $ ~O.OO
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
pai~04 0 0
Date 17 n 4--
11 7J 4 0
Receipt No. ~ 179 /
Bf~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714