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HomeMy WebLinkAboutPlg Permit 03-0076 Date Rec'd , I I '.. , , CITY OF PRIOR LAKE PLUMBING PERMIT REQUEST FOR FINAL INSPECTION SENT TO HOMEOWNER 5/03 Fil. City w Applicant I PERMIT N003- 7 b I I, jZONING'_=l (P{<uo ~ ...print ODd... "boclDm) I ADDRESS \ ,\ ~ l.q Ll.) tel ~~ -t1LL . LEGAL DESCRIPTION (office use only) LOT ADDITION PI~-37t>- (Address) APPLIC (Name) (Address) \ ('-tL~ hd . (Addre s) hone)'- \5- '"0&0-& IlIJI_ ~-e- t ~ ttua~D\ SLID 1 ~ (City) (Zip Code) (Phone) PPLICANT SIGNATURE DATE (Contact Person) 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 1 Water Softner Lavatory (Bathroom Sink) Stand Pipe (Washing Machine) Laundry Tray (lor 2 compartment sink Sewage Ejector Shower Stall Backflow Assembly Sinks Backflow Assembly Test Bar Sink Lawn Sprinkler Water Closet (Toilet) Other REQUEST FOR FINAL INSPECTION SENT TO HOMEOWNER 8/19/03 FEE SCHEDULE b cost with a $39.50 minimum Residential, New One & Two-Family $99.50 Residential, Additions & Alterations $39.50 Building Permit # PLUMBING. PERMIT FEE $ STATE SURCHARGE $ TOTAL PERMIT FEE $ (?,q ,5LJ {j .50 Lf ',on (Office Use Only) his Application Becomes Your Building Permit When Approved \ ! ,.k' Building Oftlclal Date Paid ~~ Date 1-/1-3 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 / DATE TIME CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED z .".o~ ADDRESS / 7 / 4 t. WI (.,/1) G}e..;J {;JS T>t..A- OWNER CONTR. PHONE NO. PERMIT NO. ':? . 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 o PLUMBING FINAL o MECH FINAL o EXlGRADIFILLlNG o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST o COMMENTS: ~ o WORK SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING Inspector: Owner/Contr: CALL ~7.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY! IliSJ(OT/