HomeMy WebLinkAboutPlg Permit 04-0800
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CITY n~ PUTOR TJAKE PLUMBING PERMIT '
JUL 2 8 2004 u
REQUEST FOR FINAL -
INSPECTION SENT TO
. leasetypeorprintandsignatbottom) HOMEOWNER 01-05
ADDRESS '190 13 J2{arJ l'.ew R& ~ LU
LEGAL DESCRIPTION (office use only)
LOTI BLOCK z.. ADDITION ISI--. v,CJA! ~
ile
:ity
lpplicant
PERNlf;I~U(?~. 0800 j
ZONING (office use)
PID Z~ zS?'. 0 fJt', 0
'~ I
&'::e~R C~:matJ) t . en ~ ~ i (Phone) 'f[;B-J.{rfb- h t/bl/
tSft,/) ~ /f.':ecS R J tJ uJ . Pt2JbYlaJ:r; )Av... 5537J
- . . " - - l .
~:;~~h fJ, . Pl'~~ . (phone) foS/-3~- Gt{O
(Address) 12WJO ~d' (2.J. to-~ ~ 5Sl2j
. (Address) U (City)" (Zip Code)
(Contact Person) .~ (Phone) CoSI-,3 (,-5- 0 <tU
APPLICANT SIGNATURE b.R~ ~.~.A/lc~ DATE 't1df:J1a;-
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)
. (Address)
,A"-
Quantity
I
...
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
I Backflow Assembly Test
I Lawn Sprinkler
I Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
~
Estimated Cost $:100 Building Permit # 04-, 0 BoO
PLUMBING PERMIT FEE $ .J1I5f!J
STATE SURCHARGE $ J: f#-SO
TOTAL PERMIT FEE $ lib. .-
v .,
I Paid L()
. -r' , C1J
Date 7,30. fA
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
. Receipt N~7S75'
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
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
15{g 1.>
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED ~~
I~)J V~~V
CONTR,
PERMIT NO,
L( - 600
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
)( (J.-~) f4 Ir--
~ORK SATISFACTORY, PROCEED
o CORRECT A7f;N AND PROCEED
o CORRECT OR, ALL FOR REINSPECTION BEFORE COVERING
Inspector: A. Owner/Contr:
CALL 44}.d;lr:OR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUiREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSNOTl