HomeMy WebLinkAboutPlumbing 03-0865
CITY OF PRIOR LAKE
INSPECTION NonCE
ADDRESS 3()~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED ,1~ ('OJ
tJ~ak Ae-c....
CONTR.
PERMIT NO.
>,
Plo{
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
. D.j3ASLlNE AIR TST l
~ L...._ SOl iv. <L
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W K, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 7- 50 F R THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE ;~ENTS ARE FOR YOUR PERSONAL HEALTH.t SAFETY!
H<SNO"
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File
2 Gold City
3. Yellow Applicant
I PERMIT NO. 03- fh5l'
(Please tyPe or -print and siJm at bottom)
ADDRESS
'60v&'
\Nood-lutK lJv Nw
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT I BLOCK
I ADDITION
,
,:<.., d
PID~5' - 331- tHX-O
. OWNER
(Name)
(Phone)
(,1;)'103- 5181
(Address)
(Zip Code)
Quantity
Type of Fixture
)(
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backtlow Assembly
Backtlow 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
of)
Estimated Cost $ \ f){)-
Building Penn it #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
1-. q . f:i)
,50
&.to. 00
~ffice Use Only)
,'his Application Becomes Y onr Building Permit When Approved
Building Official
Date
I Paid Llt).-
I Date 7-1-3
. Receipt 4Lj R ~ '3
By CJI-c0
V
24 hour notice for an inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave" S,E" Priur Lake, MN 55372-1714