HomeMy WebLinkAboutBuilding 15-1528 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED *1C-l (p
ADDRESS S ( ZZ \/\-; v\(� �i,�1r'\/\ C.
OWNER CONTR.
PHONE NO. PERMIT NO. S - , S Z�)
❑ FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
❑ FOUNDATION 0 MECH RI 0 COMPLAINT
❑ FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
❑ INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
❑ FINAL 0 PLUMBING FINAL GASLINE AIR TST
❑ SITE INSPECTION ❑ MECH FINAL
COMMENTS:
UG-Q.S2
WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector.. i Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
"SNOT'
01 PRj0,, Date Rec'd
ti AN CITY OF PRIOR LAKE PLUMBING PERMIT
to
I.Blue city PERMITNO. S
tM�� 3.Yellow Applicant J/ �,(Please type or icia
ADDRESSZONING(oaicc use)
�y
� nd VYi (oor - .SE=' _
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER----v... ..(1
(Name) �'` �( � .J„J 1^ (Phone) -c940 -3ZJ�'�
(Address) I I L/I Kd n / (bVCfS
APPLecf COWafe Pi304, --5:7165R-0- 4:9-9 .5"(N� K-� - ��/ (Phone)
(Address) 1-l.J X. Los aleJ2f/2c )/2, M/V 550(j
(Address) (City) (Zip Code)
_ (Contact Person) (Phone) 30 -5R -4- 5Z
APPLICANT SIGNATURE 7,..4.e
,.. . DATE /G2- /CSS -!V
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain / Water Softener
Lavatory(Bathroom Sink) Stand Pipe(Washing Machine)
Laundry Tray(1 or 2 compartment sink Sewage Ejector
Shower Stall _. Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet(Toilet) Other
FEE SCHEDULE
Industrial,Commercial&Multi-family 1%of job cost with a$49.50 minimum Residential,New One&Two-Family $149.50
Residential,Additions&Alterations $49.50
Estimated Cost $ Building Permit# •
PLUMBING PERMIT FEE $ Lig
SC)
STATE SURCHARGE $ $1.00
TOTAL PERMIT FEE $ 5Q . 5 ) j,
(Office Use Only) ar`�-4 jt / Z 3
This Appli y'•do i Becomes Your Building Pe it Wh Approved Paid j Receipt No. 3/16, s_
I►,i!� )2. 2y . Date , ` ( By /IA.__
2- 1
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372