HomeMy WebLinkAboutPLUMBING 07-0711
DATE TIME
CITY OF PRIOR LAKE Js,(S--r;
INSPECTION NOTICE SCHEDULED
ADDRESS 4/71 1*,,f;L-~ ~-
,....
OWNER CONTR.
PHONE NO. PERMIT NO. 7-7//
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o FOOTING o PLUMBING RI o EXIGRAD/FILLlNG
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL o GASLlNE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS: if)... 0 srf
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'WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ,"f'R WFOR REINSPECTION BEFORE COVERING
Inspector: , /. Owner/Contr:
I I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(Please type or print and si~ at bottom)
ADDRESS
Lf J 7 I Jtf-V--; fct~
; ~~ ~:~ I PERMIT NO. 07, 0 '7 , ! \
J Yellow Applicant
5531-2- ZONING (office use)
L-vt~
S~
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PIDz..~. Lizs. 62.4-.C]
OWNER
(Name)
Wh,'~,",
I
Sa,,wJ .
(lo~rt Oo{'"(V\.~(\
a ~ f\;bo ve.-
(Phone) ~ c;'Z.. i.f!:f 0 - II J 7-
(Address)
(Address)
Cui..i..Iui\l-. ~'~,;";cn OON-UI TlONING
6030 CULLIGAN WAY
MINN1:.1 UN~A. Mci 60345
(952) 93~ 7200
(Address)
(Phone)
APPLICANT
(Name)
(City)
(Zip Code)
(Contact Person) ~ de.' fl ,:;Jone)
/APPLICANTSIGNATURE .'WYt-dM- eJw!JJk . DATE
It' lj
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
Show~:r Stall
Sinks
Bar Sink
Water Closet (Toilet)
1~LI /~'7
Type of Fixture
Quantity
I
Rough-ins
Water Heater
Water Softner
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 $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
:J1J(1
4t;!!L
$
$
$
Estimated Cost $ 2Q1, OQ
Building Official
Date
Paid ,-ft) 0 C
DateB I. t) 1
1N09Z'JC<
-,'
(Office Use Only)
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave" S.E., Prior Lake, MN 55372-1714