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HomeMy WebLinkAboutPlg Permit 03-0581 Date Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT REQUEST FOR FINAL INSPECTION SENT TO HOMEOWNER 6/03 File City lW Applicant /' PERMIT NO'03- ~ I ~S15-) c (Please type or print and sign at L . .,.....) , ADDRESS 15i77 St~~ Ctrd~ S~east APPLICANT ~ \ \ \ 1':>\ b (Name) .,->Ofp\ClW\, LlNV\ '^Q (phone) (Address) Zq~~ 6~~JcI Bv(l. So. M.t\ls (Address) . (tity) (Contact Person) k\/ (Phone) ~PLlCANTSIGNATU~ ~~..-z-- DATE 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 LEGAL DESCRu- lION (office use only) LOT S BLOCK L/ ADDITION , OWNER I \, \ d . ('J (Name) ----VJ I ./i.J~'t'\u.{..K (Address) 1f>t.[]J S~~ Clr. S.~. Quantity ( I R"..~;nli- REQUEST FOR FINAL INSPECTION SENT TO HOMEOWNER 8/19/03 PID~5-oq/~ {)JtJ-O (phone) (1S"Z~ L/!D- 2Sb 7 (i4lZ) 82,- 4033 S5'1tJ! (Zip Code) 5/3/03 Type of Fixture Rough-ins Water Heater Water Softner Stand Pipe (Washing Machine) Sewage Ejector Backflow Assembly Backflow Assembly Test Lawn Sprinkler Other FEE SCHEDULE I cost with a $39.50 minimum Residential, New One & Two-Family $99.50 Residential, Additions & Alterations $39.50 Estimated Cost $ &otJ.(Il) Building Permit # PLUMBING PERMIT FEE $ STATE SURCHARGE $ TOTAL PERMIT FEE $ (Ot1iee Use Only) . r-rhiS Application Becomes Your Building Permit When Approved v. \ "f Building Omelal Date &j.St> .50 '" 0 . tJ6 . Paid liJ ~ 00 Date 5-16-0~ . Receipt No. ".fl LlL/5"7 i By. q-u 14 hour notice for III inspections (951) 447-9850, fo (951) 447-4145 16100 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714 / CITY OF PRIOR LAKE INSPECTION NOTICE OA TE TIME SCHEDULED z. . 17, 6 to ADDRESS /~+77 SIt-MAl (!A~ OWNER CONTR. PHONE NO. PERMIT NO. 3,58/ o FOOTING o FOUNDATION o FRAMING o INSULATION o FINAL o SITE INSPECTION o PLUMBING Rl o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL o EXIGRADlFlLlING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GAS LINE AIR TST o COMMENTS: INSPECTJONLEITERS OUrl" -REGElVE CLesit-FILE DBE Te INArUVITY o WORK Sf T1SFAC"' DRY. Fr":-~:r:; 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! INSItOTJ