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HomeMy WebLinkAboutPlumbing Permit #03-1039 Date Rec'd CITY OF PRIOR LAI(E PLUMBING PERMIT REQUEST FOR INSPECTION SENT TO HOMEOWNER. (Please type or print and sign at i FEB. 2004 ADDRESS 3~}1 I. Blue File 2. Gold City 3. Yellow Applicant PERMITNO.!)3---IO~9 Lot/4 'B~CA'1U,^- N. JJ LEGAL DESCRIPTION (office use only) LOT8li?LOCK I ADDITIoNJ{~@a./1<JGf ;;t tvrl PID!15- 3?I-03C-O , ZONING (office use) 1/50 ~=~R (J:rrlfN IfoAJ Cl (fhone) q<;2 -If</o -16?8 (Address) ~ d-! -z... LPtu.. rs'1t Cd~A tJ. J .p~O'" ~tu.. ~;~~ANT cJ~ tfvN() (fhone) 7r'J-Yl/o-/{gt (Address)3J...JL10~ fl.;/HlL Uttt.L^ jJ"lJ f"",\o'"\"~_ rr~T!~ (Address) '\AHt'b ~ (City) (Zip Code) (Contact Person) Doi:iteJ -1/.0 tJ LS (Phone) C](} -YI./ f).... /.(, ~ f' l'PLICANT SIGNATURE'~lltrlf ~_~- DATE APPLICANT PLEASE COMPLETE 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) Quantity Type of Fixture Rough-ins Wate~ <Wafer Softner~ Stand Pipe (Washing Machine) Sewage Ejector Backflow Assembly Ba~flow As~mbly Test (....-Law~~_~rin~ler ) utner FEE SCIIEDULE 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 (Office Use Only) Estimated Cost $ Building Permit # PLUMBING PERMIT FEE $ 3 9-- ~ U STATE SURCHARGE $ .50 TOT AL PERMIT F]]:E $ tLfJ w --- Building Official Date Paid Llo ;::---" Dr/5~3 Receipt NO".. I"//.:. r- UL/X77 B~_' - "his Application Becomes Your Building Permit When Approved 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 16200 Eagle Creek Ave., S.E.~I Prior Lake, MN 55372-1714 DATE TIME CITY OF PRIOR LAKE INSPECTION NOTICE ;2.-25'-0, JL\0~~~lv+('- SCHEDULED ADDRESS OWNER CC.NTR. PHONE NO. PE:RMIT NO. "5- /0)( o FOOTING o FOUNDATION o FRAMING o INSULATION o FINAL o SITE INSPECTION o PLUMBING RI o MECH RI o WATER. HOOKUP o SEWER. HOOKUP o PLUMBING FINAL o MECH FINAL o EXIGRADIFILLlNG o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL A~~~ COMMENTS: / l / /~) I L,..- V / C I L./ V /" '-7 D ". 19- i^ 1/ 1..J ~RK SATISFACTORY. PROCEED o CORRECT ACTION AND PROCEED o CORRECT. LL FOR REINSPECTION BEFORE COVERING Inspector: Owner/Contr: CAL.. OR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODll REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY! .rI'iSNOTl CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED DRESS 32 ~ '2- UJ..<-, ~( OWNER CONTR. PHONE NO. PERMIT NO. o FOOTING o FOUNDATION o FRAMING o INSULATION o FINAL o SITE INSPECTION o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL O~ COMMENTS: DATE TIME 7-'5 {',r S /' L0.31 o EXIGRAD/FILLlNG o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL E GASLlNE AIR TST ~ Ltw...~ ~~ IU~ ~t+______ ~~ cyL-~ / o ~SATISFACTORY, PROCEED ~~~;ECT ACTION AND PROCEED ~ORREZ2!<' C LL FOR REINSPECTION BEFORE COVERING Inspector: Owner/Contr: CALL ~ FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQ~MENTS ARE Fo.R YOUR PERSONAL HEALTH &: SAFETY! INSNOTl