HomeMy WebLinkAboutPlg Permit 03-1086
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
8. let. Q3
REQUEST FOR INSPECTION
SENT TO HOMEOWNER. L Blue File PERMIT NO
FEB. 2004 2. Gold City ./l?-la~J
3. Yellow AppliCllllI v.J- '(.If:)
(Please type or oriDt and sian at b.........)
ADDRESS .344'(; WIU()W' e~ 7;):2;"t1L-
APPLICANT 0 T n PI L \
(Name) f' r lJt...Wll:h ~
(Address) J 77 D L--JJ.~ \[011\. A-\J -e (~
(Address) I-
(Contact Person) R6> he~V'..J- f a.....j e-.
('''PLICANTSIGNATURE ~J~ /~
. , /
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor;
Shower Stall
Sinks
Bar Sink INSPECTION SENT TO
WaterCloset(ToiIe1 HOMEOWNER 01-05
LEGAL DESCR1r uON (office use only)
LOT BLOCK
ADDITION
OWNER
(Name)
(Address)
Quantity
REQUEST FOR FINAL
ZONING (office use)
PID Z.5.1~. 0/4. 0 .
(phone)
(phone) Cf 6;1-1/7 ;J-c:' l./7&
. t.aJ<~\J; H t: ,tpS;CJ~'-/
(City) (Zip Code)
(Phone)
DATE
1$- Jt7 -~ ~
Type of Fixture
x
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
FEESCIlEDULE
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 $ Building Permit # 12f-/IJ B b
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
. ('his Application Becomes Your Building Permit When Approved
-- \
"'____ ) BuDding Oftlclal
Date
.39,56
.50
4--0.0 ()
paid4t? I (/l)
Date
~ lq, (J"1
Receipt No.
tHfP2-
By ,j/
o
24 bour notice for all inspections (952) 447-9850, fu (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
,~,,~
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED Z. . f1,c"
DATE TIME
ADDRESS 34-4-0 W/(.,.vOW B~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
3 . I o~ ~
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/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
SENT TWO REQ-UE.STS FOIL
INSyEl.;'llONL:E:I';I'ERS uUI
RECEIVED NO lU:SPONSR
CL
T9
lNA CTIVITY
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!
I/i~OTl