HomeMy WebLinkAboutPlumbing Permit #04-0822
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/09~
hfL'/
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
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DATE TIME
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o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
~ASLlNE AIR TST
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~ORK SATISFACTORY, PROCEED
~ ';;ORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR EINSPECTION BEFORE COVERING
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CALL 447-9850 FO~ THE NEXT INSPECTION 24 HOURS IN ADVANCE.
Inspector:
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY/
Rug 04 04 02:2Bp
TV
AUG-04-2004 16:24
CITY OF PRIOR LAKE
p. 1
9524474245
P.01/01
ell l' OF PRIOR LAKE PLUMBING PER!VU.l
Date Ree'd
S. 5'.04-
~: = ~~ PI..KMITNO.~ A.""
] VII" ",,11",,1 ~....
(P1aJe ewe orl)rint and str.D u bodOrn)
ADDRESS I Lf J99 rIY-~( AV'f
ZONING (oIBce \lie)
LEGAL DBSCRlr j. JON (olic:e Ule only) " -ch
r.ar3 BLOCK / ADDmON.~ )/OrtJ, 5/;6/"6 U~!(G r; ruJ 2-5.2.(,1-. 00.3.0,
~
OWNER
(N~) -
(Address)
(phone)
~~~"P\(a:<t\qLkt- '11u IA1..0I11Dj. (phone) (0D- *,'i~/?j;
(Addttss) l()~/(\ fJiMt~/~J -eJ\JW}J()J ((JJ:M ucoj'cls UN ~\Y1n
(Addle!s) r I (City) ) (Zip Code)
(Contac.tl'enon) _ UeJ1.f- t' 1fJ- ~_ _ (phone) tJ;/a ~ SYR- .-fS10J,
APPLICANTSIGNATURE ~ ~ DATE g-....If-rJ. L/
v I
APPLICANT PLEASE COMPLETE BELOW
l:ype oiiftttare Q~lUItity
Bath TlIb with or without snower
Dishwasher
, Floor Drain
Lavatory (Bathroom Sink)
Launclry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
Quantity
1 W4Kk ~ lJf. ~LI-
Type of Fixture
Rough-ins
Water Heater
Wat~r Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backftow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other a(j,(j 10 d~r
V . ()
FEES(.n.fJDULE
Industrial. Cclmmcrci.u II. Multi-family J~ of job COlt with. $30.50 mlnimum Residential. New One &. Two-Family S99.S0
kesidcntiaL Adl1itirms &. Altcruions ~9.S0
E.\timar.ed Co~t $ f?oo l (J1) Building Pennit # 0 +-" O~ z, Z.
PLUMBING PERMIT FEE $
STATE SURCHARGE S
TOTAL PERl\fiT FEE $
(oma:e Use Onl)')
This Applieation Becomes Your Building Permit When Approved
.aildi~fl: Omdal
Datr
~~1~ SO
.50
"10.61)
Paid .ftJ. tAl
Date 8 . 5,0 4-"
24 hour notice 101' IJJ inJpecdons (952) 441-N50, fa (9S2) .f41-fJ~5
16100 EaeJe Creek Ave., S.I:., Prior lAke, MN 55372-J71.
o. 4161/1
TOTAL P.01