HomeMy WebLinkAboutPlg Permit 04-0714
CITY OF PRIOR LAKE PLUMRING PERMIT
Date Rec'd
7./Z,;O+-
REQUEST FOR FINAL
INSPECTION SENT TO
(Please tvDe or print and siRll at bottom) H 0 MEO WNER 01-05
ADDRESS -.
'LttloD ~bu n--\f)1" Th 1~~ (1+ ~\
ue File
lid City
lIow Applicant
I PERMIT NO'Of: 07/4-1
ZONING (office use)
LEGAL .JBSCRIr nON (oftke"" only)!,. . ' d
LOT!J BLOCK e>ADDITION F Lil..U\t~ ~ a~
PIDJ.5"" 810'" ()L\~-D~
. (PhOne~~ ~ d lfD3 D 1 Lt::)
\4-lll'\ Q:t- t-J
OWNER ~'^ . ~ 1/
(Name)<. \\1_'_ \y\ \ e____ \[-.Jll ~~
(Address) \ 4\\.oD :;i)ll\\:fti f,
~~~~ QWJ~ \Q.l1 !eJ-{lJI ff))~t [15.. ?-$.I n >!fJ In J
(Address) lJl~ On - ~a Pr ~ to t+7JC1t~{}IlmJ ~t0
., (Addre: s) (City) (Zip Code)
(Contact Person)~ l. r'Y\ A (Phone)
-'.- APPLICANT SIGNATURE ~.~./. DATE / II t7 / (5Z/
/ ~PPLICANT P~EASE 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)
Residential, New One & Two-Family
Residential, Additions & Alterations
Building Permit # 04-. () 7/4-
a05D
.50
LID .DO
Quantity
't
/
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
Estimated Cost $
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
I This Application Becomes Your Building Permit When Approved
Building Official
Date
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing ~chine)
Sewage Ejector ·
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
$99.50
$39.50
$
$
$
pai~. 00
Dat~. /31 04-
ReceiptN~72 7/
By /fbf
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
ADDRESS
//(1 h rJ
DATE TIME
SCHEDULED ~~~-""
~^ftr,~ &/J C~
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
7"- 7/7
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
~UMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPUINT
o FIREPUCE RI
o FIREPUCE FINAL
o GASLlNE AIR TST
o
COMMENTS:. ; /
lA/a T~ r
r ,,/-
( \~ rl//&r
/'7
~/
~. Ij It-
( /L--
~ORK SATISFACTORY, PROCEED
RCORRECT ACTION AND PROCEED
o CORRECT W,/ :,~Ly6R REINSPECTION BEFORE COVERING
Inspector: Jf~~ Owner/Contr:
, ./
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH cl SAFETYI
INSNOTl