HomeMy WebLinkAboutPlg Permit 03-0283
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 5/03
3~-11-o3
I. Blue File
2. Gold City
3. venow Appliconl
PERMIT NO. 03 - 0 2~ ?
(Please type or print and SUln at be:
ADDRESS ~f61S Cenfe.r Rd.
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 8/03
ZONING (ofticeuse) I
LEGAL DESCRu"uON (office use only)
LOT ,~LOCK '1 t\ ADDITION
~ ~~nJ
PID~"'l31' b5q~Jr
6m;1J;tt .1 Wfflj
2-~1\C) CUtter Rd.
~;;~~ANT NOrbL()YY1 PLwrLbina ~hone) (l1itvJ 82f1~L{O?3
(Address) 2.flOS f1a1'fr'Wl AY ~~ SD. rY1JfJ is. 5'dJo'l
(Address) (d.ty) (Zip Code)
(Contact Person) (Jeff tJOfJ:/1 fiYV'- (Phone) ({p/2,) t'l-7-4D?;?JJ
0PUCANTSJGNA~RE 1f1/\--- DATE 6('6'/6'3
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (1 or 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
OWNER
(Name)
. (Address)
Quantity
~hone) (qfJ2) m-Z?ffrt
Type of Fixture
I
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backtlow Assembly
Backflow Assembly Test
Lawn Sprinkler
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 $ 2iJO
Building Permit # ()3 - 6 z,fj.3
r ?fl. f!2
- .50
LI-O. o~
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
/
(Offiee Use Only)
~his Application Becomes Your Building Permit When Approved
Building Official
pa~o ' CIV
Da!1_ /1 ,-OJ
/
/
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
ReceiPt~957
By .>/
~
V
Date
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
z,n.o I.:.
ADDRESS
z. e 7 ~ e6)t/TDc:...,c.o .
OWNER
CONTR.
PHONE NO.
PERMIT NO.
3 . zfa
o FOOTING
o FOUNDA TIOH
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
:: COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
SENT TWO REQ-UESTS EOR-
INSt'EC'11lJNLE1IERS uUT
---R.ECJfJVED NQRF,SffiNSR
T{}
lNA CTIVITY
,-: "SAT1SF/.:':;TOf:), i ,.CEE:':
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!
IXSNOTI