HomeMy WebLinkAboutPLMBG 05-0437
THIS FILE HAS BEEN
CITY OF PRIOR LA CLOSED DUE TO
INACTIVITY 4/18/2008
REQUEST FOR
INSPECTION SENT TO
HOMEOWNER 01-06
Date Rec'd
5. /7. oS
File
City
1/ Applicant
I PERMIT NO. O!:. 0 ~ 37/
ZONING (office use)
/!? IsD
, ~...., \
i ,
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID 2-5. 12-4-.00Z.0
OWNER
(Name)
(Address)
i
1 )
,I 1-
(Phone)
J .,~
APPLICANT
(Name)
H.P. PIPEWORKS
3670 DODD ROAD
EAGAN. MN 55123
(6~~dA6ij 1~'J
(Phone)
(Address)
(City)
(Zip Code)
(Contact Person)
r!
(Phone)
.<\PPLICANT SIGNATURE
i 1,. .
DATE
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher I 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 REQUEST FOR FINAL Backflow Assembly Test
Bar Sink INSPECTION SENT TO Lawn Sprinkler
Water Closet (Tf Other
APPLICANT PLEASE COMPLETE BELOW
HOMEOWNER 10-06
r J'...... ~'--..L.u '--' LJLJ
Industrial, Commercial & Multi-family I % of job cost with a $39.50 minimum
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $ -)11.
Building Permit # tJ 5: 0 4-:3 7
(Office Use Only)
This Application Becomes Your Building Permit When Approved
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.50
Building Official
Date
Paid .:fO. {JO
Da~ 17. OS-
Receipt N04 920 0
By
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
. ~ .