HomeMy WebLinkAboutPlg Permit 04-1182
CITY OF PRIOR LAKE PLUMBING PERMIT
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 01-06
,t'1eue tyPe or PriDt and sian at boUo
, Auu1\.ESS
g~/5 Sprlnq (q,ke Rd.
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LEGAL DESCR.1r uON (office use only)
Date Rec'd
JJ.V-. ~4-
I. Blue File PERMIT NO ~
2, Gold CIty, . 0 + "L11J.,
3, Yellow Applicant - t'V
ZONING (ofIk:euae)
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LOT BLOCK
ADDmON 13V7fl!;)v./t/I .8~f
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APPLICANT H ·
(Name) P P/~W6(J::S
(Address) "3h 7 D D txJd RtJ.
(Address)
(Contact Person) Kef ca 0 ~
J!1lW 0 ~
APPLICANT SIGNATURE
(phone) q?~- 4lf5 - 'Vi 0 I
1f"ff7ii'- ' "7J1J(;'" ,., '." '_-""T_"_~. -'...,"
, or -.\,~' ",' '0' ,
(Phone) &/5 J- ?i.o':S - I '"by 0
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(Cit;1 (Zip Code)
(Phone)
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I II? ) () 4-
DATE
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,: I APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher , Water Heater
Floor Drain I Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall Backtlow Assembly
Sinks Backtlow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
FEE 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 $ ~
Building Permit # rJ4 # II B z..
$ .::JtHJ7S 39. 50
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PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
This Application Becomes Your Building Permit When Approved
,,..-...,
Building Official
Date
Paid 6
HJ. ()
Date
II ZZ. 04-
Receipt No. .,fB:3" 4-
By jjju
/
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
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
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l..G/q/ t..-- r
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DATE TIME
SCHEDULED 41- 1:6#~ I 3~
~/C; SlJA;/~/( U Rd
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CONTR. V
PERMIT NO. (2) Lf - I / ~ ~
o PLUMBING RI 0 EXIGRADIFILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLINE AIR TST
o MECH FINAL 0
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~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR;..;~LYJr REINSPE N BEFORE COVERING
Inspector: ~./ Owner/Contr:
CALL ;"-9850 F~E NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH 41 SAFETY!
INSNOTl
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