HomeMy WebLinkAboutPlg Permit 04-0125
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
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. ADDRESS
b 16"0
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 01-05
Rus-l::::c. Road 5o~g;
. File
d City
ow Applicant
I PERMITNOOJ/~ )~51
ZONING (oflice use)
~/5./)
LEGAL DESCRir lION (office use only)
LOT BLOCK ADDITION r X PIDdS'/'-I/r O/O-~
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OWNER H 1J7A}~ dl KCh1 /S),~PY1 (II'S,) 4"~ - 21 Cfl
(Name) (Phone)
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(Address) G,7SO Ru~/;-,'"l- Rc~d S~E.
APPLICANT "' b' Dl b
(Name) N () r lc:.vv\., v..-w\ \'~,
(Address) 2'O~ 4~-e..Jol Av-I.. ~".
(Address)
(Phone) l" 12.) 32.1- '/4.13
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(City) (Zip Code)
(Contact Person) Art.t1hlL
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,,("PLICANT SIGNATURE ~~.-~
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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 comnl'lrtment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
(Phone)
DATE
Z/ 27/''1
Quantity
Type of Fixture
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 01-06
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
, Sewage Ejector
ackflow Assembly
ackflow Assembly Test
awn Sprinkler
Ither
11 J!..I!; 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 $ ,-/_!!P
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
31.60
.50
'/t) - tJO
(Ot11ee Ule Only)
.r \"his Application Becomes Your Building Permit When Approved
Building Omelal
Date
. Paid
t/f), --"
Da~_I'j_()4
Recei2fl,L/I ~
By
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
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CITY OF PRIOR LAKE
INSPECTION NOTICE
OA TE TIME
SCHEDULED
Z..11.0fe,
ADDRESS
1I16D rw511~ tUJ .
OWNER
CONTR.
PHONE NO.
PERMIT NO.
Lf . (z..~
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RJ
o MECH Rl
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
SENT T .STS EOlL
INSpEc'11ON :LE'I'IERS uUr-
-RECEIVEnNO RES.PONSF
TN ACTIVITY
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!
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