HomeMy WebLinkAboutS/W Permit #00-0212
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YELLOW - APPLICANT
GOLD - CITY
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CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
S.W.No. 07J -02/L
NOTE:
Sewer and Water
contractors must
be registered
with the city.
Aal'LICANT: (] . I ~/~Jd' C ~ .s
ADDRESS: ~//("g>6 /)ft!4/(l-/("L.4 #r<-
SIGNATURE: ~ a~
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SITE ADDRESS: S3 /3 /-s/IJ -r11 S"r
P.HONE: II). - ~,/ - $;J.K I
JIId Au DATE: -t" - /d - 00
BLDG. PERMIT # (f7) - 0 z.,f Z-
AI./?', PID#2~-00&'- 003-0
FILL IN THE BLANKS
1. Estimated length of water service
feet.
2. Size of water service
inch(es) .
3. Location of any couplings from structure
feet.
4. Type of sewer pipe. ABS
PVC
cast Iron
5. Estimated length of sewer line
feet.
6. Clean out (if required), located at
structure.
feet
from
------------------------------------------------------------------
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BY
This
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FEES:
$
$
$
35.00
.50
35.50
Sewer and
Surcharge
TOTAL
* Fee for either sewer or water individually is $)1.~ plus
$ .50 surcharge.
*
Sewer and water permits issued for new construction must be
recorded on the building permit card at the time of issuance
to insure that no duplicate sewer and water permits are
issued.
~!t J (fll
, f
3/15-V
AMOUNT PAID
RECEIPT #
REC'D BY
Ii. rV
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)
DATE PAID
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230/ FAX (612) 447-4245
An Equal Opportunity Employer
-
I
TIME
DATE
CITY OF PRIOR LAKE
INSPE;;TION NOTICE
ADDRESS
.~313
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f
Itlt) tI- - .
CONTR. c; - F> ~, ~ J)
PERMIT NO. tJO - O~
SC
DULED
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
~ ~ WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP It: 0 FIREPLACE FINAL
@ if PLUMBING FINAL ~(2) 0 GASLINE AIR TST
1"0' MECH FINAL 0
COMMENTS: (j) ~ ~.
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(~I'~ ~ '-" tr1- . J
o WORK SATISFACTORY, PROCEED ~L 'i-u Ct~~
,"CORRECT ACTION AND PROCEED ~ ~
o CORRECT W~K, CALL FOR REINSPECTlON BEFORE COVERING
Inspector: ~ Owner/Contr: .r
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI