HomeMy WebLinkAboutPlg Permit 04-0118
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
~..?s
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
DATE TIME
SCHEDULED ~ /~/
Cbe/Ioo~ 4-
CONTR.
PERMIT NO.
'O~ -//p
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
..z:::nUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS: I /
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[WORK SATISFACTORY, PROCEED
o CORRECT ACTION AN~PRO ED
o CORRECT WOR~ REINSPECTION BEFORE COVERING
Inspector: / f' I]; Owner/Contr:
, .,v
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSIIOTl
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
:3. tf. 0 tJ.....-
REQUEST FOR FINAL
INSPECTION SENT TO
(Please type or print and si2l1 at bottom} HOMEOWNER 01 05
ADDRESS -
LjIA':j~ ()/Jd2)lJ!JJ( \liz. (~
~::~ ~~~ PERMIT NO. 0 A. () / Jo,
I. Yellow Applicant q' Il;/
ZONING (office use)
LEGAL DESCR.1.t'uON (office use only)
LOT
BLOCK
ADDITION
PIDZ.S. z,'4- _ ()3 Sf..,>
OWNE~/""\' n
(Name)!/ I/(J/J~j/~ P-/UL~
(Address) LJ&a [) !JtYC...J~ k
(Phone90 Q) -tlL)7-' )g <5 /
APPL~T /"rn 11. 'A
(NametJ! L-rr'l D it: t L 'b_/
(Address) 5-"/ ~ f'!ft-! M
. (j(ddress)
(Contact Person~/ 1 fYJ
,,-.- "PLICANT SIGNATURE ..LJ/ir
/
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V'-tJ LtJ:k..e
J) fY.e )[)2/
(Phone) ;/S r~8.0-;rt2lj7
#~a.4l)/) /.I))~O)&
(City) (Zip Code)
(Phone)
~M~
DATE ~ "3/II!fZ-I
- -
I
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 (l or 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
FEE SCHEDULE
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
Estimated Cost $
Building Permit # 04-. 0/ Ie
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(~q.,5D
-, .50
4D.DQ
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid 4-0. 0 0
. D~. 5. 1)4--
Receipt ~ Z 7 z..
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