HomeMy WebLinkAboutPlg Permit 05-1091
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
/0. Z-fJ. OS-
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 01-06
(Please type or print and si~ at bottom)
ADDRESS
HANSON, SCOTT
4130 WINDSONG CIRCLE NORTHEAST
PRIOR LAKE. MN 55372
LEGAL DESCRL.l"TlON (office USI (952) 226-5044
NORBLOM PLUMBING CO.
(612) 827-4033
~JPAKFIELD AVE. SO.
MINNEAPOLIS, MN 55408
(Contact Person)
PPLICANT SIGNATURE CdIJJjJ.. .A.t.JJJ.I.J.)tfLA---- DATE
l/
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)
LOT
OWNER
(Name)
(Address)
APPLICANT
(Name)
(Address)
Quantity
BLOCK
ADDIThn,
I ~:~ PERMIT NO. 05". /09/
)w Applicant
ZONING (office use)
PID Z5. 2.3". OoZ. 0
(Phone)
(Phone)
(City)
(Zip Code)
c;~, -L 2. ~
o-bth/-(.
(Phone)
1 0 23 0 5
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
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 #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
~5_'10
.50
t./fJ L't)
paid4tJ _
Date/t'. ~r,() r
ReceiPlO' 511311
BY1.
(j
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
4/10 LA.//Vlcl~v\v....
CONTR.
OWNER
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULA nON
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
/12()
1.~~4
---
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----
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[]ME TIME
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s-:- tOt{ /
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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--
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR5fALL FOR REINSPECTION BEFORE COVERING
Inspector: 1/ /;(j1 f Owner/Contr:
v .
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSI<OTl