HomeMy WebLinkAboutPlg Permit 03-0077
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
REQUEST FOR FINAL
INSPECTION SENT TO
(Please type or print and sUm at:'.;';'._) HOMEOWNER 5/03
ADDRESS
\id\'5 ~\L~~ (')o.J'f\ \f\ ~e.-
LEGAL DESCR1.r lION (office use only)
LOT:3 BLOCK 2> ADDITION
&=~~ \\ )...,\\'f\.; ~ e~e-
(Address) 'Lrlt~' ~l_CR~ T)CV\ Lr\ ~8
L Blue File
2. Gold City
3. Yellow Applicant
PERMITN~;G)3"'77
It
.1 ZONING (office use)
J Kf
PI~S-B7o-D33..0
(phone) ~tld" yq{)-l QY uS
~;~~~~, 0~f)\~ \J() }Jf~ "t-Q-6JJ.)~hone) ll5-~ -~lJJ/l
(Address) 51 ?, ('4'\ ~ ~J\ \\ ~€-.- \\)L\
(AdMess)
(Contact Person) \.. ~_ rf)
~PLICANT SIGNATURE
-\-\'uctDDrl LU\
(City)
t~,l'Jd~
(Zip Code)
(Phone)
DATE
APPLICANT PLEASE COMPLETE BELOW
I 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 (lor 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
,rJ!.ESLItEDULE
l>st with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 8/19/03
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Offiee Use Only)
rhiS ~pplication Becomes Your Building Permit When Approved
T'
Building omelel
Date
~q.J()
- .50
L/ D .DO
. Paid L/tJ".../'.
Date; -11-3
Rei!~o1 'I b
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
DA TE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
2.n.o~'
ADDRESS
/72-/5
.LfuKA- e,l/J A:- L-,J .
OWNER
CONTR.
PHONE NO.
PERMIT NO.
::? 77
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 EXlGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
SENT TSTS FOIL
11~~YEL'11ONLE'I'I'ERS ulTr-
FF.CEIVF,D NQRESPONSE
CL9-8E-FILE DYE TQ
INACTIVITY
..
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
J/fSltOTl