HomeMy WebLinkAboutPlg Permit 04-0713
CITY OF PRIOR I,AKF. PI,T™RlNG PERMIT
Date Rec'd
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1~;;~~A~ Q17 rJti t~lJPl( t--0~~hOne) 115 '?J9J.~ ~ IJ/nt
(Address) ~-r?; 0+-1'~' H ~ \JJl t\tl (\~ \ 0\\ Atbll 0
(Addres.) (City) (Zip Code) ,
(Contact Person) ~ L rYh _ IA (Phone)
APPLICANT SIGNATURE LhiY-' ~~ljJf]b.lK_ DATE //(~/!521
/ :PPLICANT 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
I Bar Sink
I Water Closet
Building Permit # O~, 0 7 /3
t ~9 .z:n
.507\
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REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 01-05
(Please type or print and sil!;ll at bottom)
ADDRESS . (\
5%'-'13
LEGAL DESCRlt'uON (office use only)
LOT 1 BLOCK ADDITION
. (Address)
~9)0\~
Quantity
I
I
I
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REQUEST FOR FINAL
INSPECTION SENT TO
Industrial. Commercial & Multi-f HOMEOWNER 01-06
r
Estimated Cost $
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
I This Application Becomes Your Building Permit When Approved
Building Official
Date
I. Fil.
Id City
low Applicant
PERMIT NO. Ot! .. 07/3
- ZONING (office use)
PIDZS: (J~&, 0 '07. 0
(PhOne~)~ ~;)I RD
Type of Fixture
/
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
Residential. New One & Two-Family $99.50
Residential. Additions & Alterations $39.50
$
$
$
Paid +0. (J 0
Dat~. /3.04-
Receipt N~ 7 Z. 7 /
BYF
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
DA TE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
Lj- () 3
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RJ
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
SENT TWO-REQ-ITEST~ FOR-
IN~.PEC'11UN' LETTERS OlTr-
-RECEIVF,QNO RE&PflN~R
CL-GSE-FILE DYE T9
lNAClJ VlIY
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!
l.HS/fOTI