HomeMy WebLinkAboutPlumbing Permit 03-0863
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED ~ -1~'O)
ADDRESS ~sI7<.a W../,O W""......Jl
OWNER CONTR.
PHONE NO. PERMIT NO. ?-8Co'5
o FOOTING o PLUMBING RI o EXIGRADIFILLING
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 J GASLlNEA~
o SITE INSPECTION o MECH FINAL LA- SP.
COMMENTS:
\
{'\j /' /
\..../'
~ORK SATISF
o CORRECT A
o CORRE
Inspector"
TORY. PROCEED
N AND PROCEED
K, CALL FOR REINSPECTION BEFORE COVERING
OWner/Contr:
.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
"""""
- --'"----------.."..------..--..----..--.-
5@':
"".\'NESO"'"
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
;:~ ~:;y I PERMIT NO'03 - \1'0 t?
3 Yellow Applicant 0 I 'f
(Please tvDe or orint and sign. at bottom)
I ADDRESS 311-1o \N~ \d ~ ~
ZONING (office use)
LEGAL DESCRIPTION (office use only)
, LOT !()p,LOCK SADDITIONJV.1.i{Jh .sD
PID;]53 X,J- /3to-()
6tt\l(' ~
SCU'V\.Q
APPLICANT" ' Itx
(Name' \ ,Ut\lI\J. l'\ "'" J (Phone) . lo\d - 8f) \- tk;l14(j
(Address) vII.{ :~€JlA.\ - &l \-\u.=-~I'(M Cfj?fYJ
(Address) (City) (Zip Code)
(Contact Person) ~ (Phone) l,,1 d -R{)\. ~d\O()
- 'PLICANT SIGNATURE "--- ~ ~ y- DATE
APPLICANT PLEASkJCOMPLETE 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)
OWNER
(Name)
. (Phone)
1 \g 3' ;;rri.l . ORm
(Address)
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
Residential, Additions & Alterations
$99,50
$39,50
5 Db
Estimated Cost $ \ ~
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
~9.3)
.50
YO. UQ
,--l()ffice Use Only)
:his Application Becomes Your Building Permit When Approved
Building Official
Date
I Paid lf6- ~
I Date7_ /0
Receipt U 1/[( g -~
By ,
rJ /
24 hour notice for all inspections (952) 447.9850, fax (952) 447.4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714