HomeMy WebLinkAboutPlg Permit 04-0763
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 01-05
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,t'lease type or print and siJm at bottom)
ADDRESS
'L\3lD \
0+
\\ L-,
LEGAL DESCRlJ:'uON (office use only)
LOT t1BLOCK { ADDITION
~
7. Zz,. 64-
; ~:~ PERMIT NO. OA~. 07'- 7
ow Applicant ." fI./
ZONING (office use)
r<17'JiJ1 .~ a1)v
~~e~R \_0~ n e_ \ f-XY\-\--L. (PhOne~~S 'd- Ll ~- I 0011 .~
(Address) 'L+??) D \ ~CS\ L 0~ + \'J t;: ~ \ c\Q , t 0Jl0 In lD 5,53-.1;2
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(Address) ~13 C~h- ~Cj J=+ ~~ [~ +11f{~ LiJl Sl{D 1 L ,JJ
(Ae dress) (City) (Zip Code)
(Contact Person) ~ \ l '(Y\ (Phone)
APPLICANTSIGNATURE/1!~ )__~-::~/ft')~/(9f-vf_ _ DATE l \ 1~ tJLI
I ' APPLICAN;~LEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor") .--nmn"rtmpnt "ink
Shower Stall
Sinks
Bar Sink INSPECTION SENT TO
Water Closet (Toil HOMEOWNER 01-06
Quantity
r
REQUEST FOR FINAL
PID z6. ~~8. 0/7. 0
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
I Other
FEE Sl.:HElJUL.t..
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 # tJ~. ()'1!,J
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
<-~5b
.50
C/!J. 00
paid..fD , tflJ
Datez z,:J. 14-
Receipt ~'7 S5J
BY~
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
DA TE TIME
SCHEDULED
ADDRESS
/ ~/3(,v I
(-----) .... U-(
f-' U
CONTR.
OWNER
PHONE NO.
PERMIT NO.
.7
1'/-/0:/
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING Rl
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
-sENT T' FQR-
~RCTJO-HLEl'rl'~RS UU'l'
-REGEI,TED NO-RESPONSE,
eL6Slt-FILE DBE-ro
IN ~L\CTTVTTY
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!
lNSHOTJ