HomeMy WebLinkAboutPlg Permit 04-1098
CITY OF PRIOR I,AKF. PT.TTMqING PERMI.
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 01-06
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&:R ~J.t.dAAJ ~. (Phone)~J.4!/IJ-4J~
(Address)/'1I.J/1o I0. ~ ~J(. ~z. LfJ~ >,(J&.t,:JYnn.. 6S.3IJ~
APPLICANT II, LJ ,f) . . l.. _ ....
(Name) ""'II T "'-U pI ~.tJ1.H..JLLJ
(Address>3.k!}b ~ F:~.!
(Address) -,--
(Contact Person) If! I} IQ Y
APPLICANT SIGNATURE CfYL4.A.-J-l
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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 (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
.~&
LEGAL DESClUr .l.lON (ofliceuseonly)
LOT 9- BLOCK I ADDITION
Date Rec'd
/0. Z/. 04--
ue File
oIcI City
ilow Applicant
PERMITNO'O~.I09~
,
ZONING (ofIic:e \lie) .
~Z-
PID25: *7. ()OZ.O
(phone) ~/-~~"5 -I?; tJ.o
m hn .s.1J I J....~
(City) (Zip Code)
(phone) JLJJ -r-:{ ~ 6 - / r-~ l./.I)
DATE 1~1t5 /,~ 4/
~
('
. Quantity
Type of Fixture
I
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backtlow Assembly
Backtlow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
Industrial, Commercial & Multi-family I % of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $ 02~ ~6-t!J - Building Permit # () ? ,10 l' Z,
PLUMBING PERMIT FEE $ .3 q. S b
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $ 4"~ 419 .
(Office Use Only)
This Application Becomes Your Building Permit When Approved
~-
Building Official
Date
Paid +tJ J (/U
Date 10. z.,z,A4-
Receipt N04e304-
By P-
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
.,. ~. tttJ
ADDRESS
/ ? ~ ..2-3
DATE
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TIllE
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
OWNER
CONTR.
PHONE NO.
PERMIT NO.
(!j~-/09P
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
--iiiJ16' t'LUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS: _. / /*"I/)/'
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~~TISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
Inspector:
Owner/Contr:
/
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .I SAFETY/
INSNOTl