HomeMy WebLinkAboutPlumbing Permit #03-0125
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS --5;1 0 '-I
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED
Ii ~-SO
1 - ~ <>"(
.~~ Si- .
CONTR.C....J.:::J. 2S ')
PERMIT NO. ,. - IC~ '- r
o PLUMBING RI 0 EXIGRADIFILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
:sLPLUMBING FIN~LuJecht- 0 ~SYNE AIR TST
o MECH FINAL I#a~ ~ ~~cJll' \.\A
<.J
~
O*(
w~~
~t~ ok.
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., . ..blrl -.__
_A I
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
~RRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector. ..()Jt~ Owner/Contr:
CALL ~.9el.O F THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIRE. 'ENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSNOTl
~PRI~
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Blue File
Gold City
Yellow Applicant
CITY OF PRIOR LAKE PLUMBING PERMIT
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 5/03
(please type or print and sign. at bottom)
ADDRESS
5 20 Y I-lvoe streLt-
,
LEGAL DESCRIPTION (office use only) 17 '_b/)1 A II ~ j '.'--: IJ_
LOT BLOCK ADDITION ~7'''(j ~CP:J~
OWNER I 11 ~II /'nntJ? .
(Name) ~ ) U~;. J li/L
(Address) :5204 lday~ cSf.
APPLICANT N rw-l/ll ~ -
(Name) VI UllJYVl . . I ;?;:J
(Address) 1,Cl D S fA ()1 f1 PI ~ ~ 60-
(Address)
(Contact Person) 0 ~'f '\' QYol C5YVl
-~ "PLlCANT SIGNATURE ~
ONING (office use)
f-150
PID~5~08D- OO'2-(}
(Phone) rQCjZ)4Lfo-7b/ I
(Phone) ({[)/b) n7-L/033
rn,OlS, tt:ElJf
(City) I (Zip Code)
(Phone) {t.0~1KJ;7 - 4D33
DATE ij1,.3 /1)3
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough- ins
Dishwasher Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 8/19/03
FEE SCHEDULE
) cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
tfOD.02
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERl\'... FEE $
(Office Use Only)
,~'This Application Becomes Your Building Permit When Approved
~
-1
Building Official
Date
~~1. 52
.50
LfO. D:!!
Paid tf{) I ~
Da/~ <30192
Rectz~ '74? 1/'
By · -(j;)
tI
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714