HomeMy WebLinkAboutPlg Permit 03-0395
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 5/03
1. Blue File
2. Gold City
3. Yellow Applicant
PERMIT NO. tJ 3--;-3 ?5-
;j
ZONIN~~ceuse)
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(Please type or print and sign at botton
ADDRESS
l~b19
D(,l,'o\ \'e\ K oa.c/ 5CJl.Lfuast
LEGAL DESCR..ll' nON (office use only)
LO{}/ BLOCK ( ADDITION PA~ ~
t
PID&5 - Df 1- tJJ1rO
~'::~~t5<m) -PCUA-\
(Address) Ibb 7Cf bu.bli'Y\ R"a.J 6, b,
APPLICANT\. \ L\ ""\'\\ b
(Name) NOrD .OW\. t" UMI\. ~-
(Address) 2~()~ tn~/;(2/d 1Jv~ ~ .
(Address)
(Phone) fctf;z) &./47 - 1"52..
(Phone)
MIJ is
(City)
(blZ) 827 -'10].3
55''/ ~~
(Zip Code)
(Contact Person)
/",,,r-ryPLICANTSIGNATURE ~~_
~~
(Phone)
DATE
3/.31 jtJ3
Quantity
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
Type of Fixture
REQUEST FOR FINAL
INSPECTION SENT TO
Indl HOMEOWNER 8/19/03
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn ~prinkler
Other
FEE SLtu~DULE
vith a $39.50 minimum
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $ 400.#9
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
1."_,,
, TOTAL PERMIT FEE $
'~ (Office Use Only)
\ l"thiS Application Becomes Your Building Permit When Approved
V
3Cf.SO
.50
40 .00
Building Official
Date
P4t 1/0/-
DatV_ 3- 3
I
ReceiPtlt./t1t/4
By 00.... '
fJ
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
DATE TIME
SCHEDULED
Z.tl.6(,
ADDRESS
j{P(;79 .oU&(,-IIV~.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
.3 . 3' 1.s:"
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 EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
SENTSTS FOR-
iNSt'EC'lIuN LE'I"rE"RS uUT
-RECEIVEaNO RRSPo.NSF
CL
T9
INACTIVITY
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspecter:
. Owner/Centr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSNOTl