HomeMy WebLinkAboutPLMBG 08-0813
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
SP18
~-
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
/0/8/0(;
) .
~~
08 -0 B(~
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
~ASLlNE AtI~ TSr
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;:::: WORK SAT!SFACTORY, PROCEED
o CORRE~ AND PROCEED
ALL FOR REINSPECTION BEFORE COVERING
Owner/Contr:
CAU...u7-~OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
~UIREMENTS ARE FOR YOUR PERSONAL HEALTH .{ SAFETY!
INSNOTl
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
x
(Please type or print and sign at bottom)
ADDRESS
1. Blue File PERMIT NO
2. Gold City . 8 - tDO , t?
3. YeIJO\v Applicant ./
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
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. ZONING (office use)
PID
(Ph<)6~) ~9 r <i \ ~
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(Address)
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APPLICANTh j
(Name) ~J
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1'\1k.. ~..L IN
(Address)
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(P)K;Jne)
r...J;)~ Xo /.. <; 7.J. b
l' (Address)
C. 5'"\ ~
(Phke) 9'fJ- ~ '1l4 1- fa J. ~
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(City) . (Zip Code)
(~tact Person) ().J cJL.-.
DATE -io ~(, -0 8
. APPLICANT SIGNATURE
Quantity
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower /
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
, Water Closet (Toilet)
Type of Fixture
Rough-ins
Water Heater ~b. ixl'<I'i
Water Softener .
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
. 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 $
STATE SURCHARGE $
TOTAL PERMIT FEE $
'I Cj. 5-')
.50
t:;o.oO
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" You, BU7:r~;; Wheu App,oved ::: 6V~, (/[)
Date IJ. ,
, , I
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
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