HomeMy WebLinkAboutPlg Permit 04-0877
Date Rec' d
rTTV OJ? PRIOR LAKE PLUMBING PERMIT
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 10-06
(Please type or print and sign at bottom)
ADDRESS
1. Blue File
2. Gold City
3 Yellow Applicant
PERMIT NO. oLj:" R ?J l'
/5d. '-7;'
:t Jj./~-r 'i?& 4f,e,
ZONING (office use)
f--( 5 f)
LEGAL DESC)UJ'TION (office~se only)
)1-/ 1- F ~ % /::J ----:fh
LOT BLOCK } ADDITION /I ! ! lit/}l"e":.j
~~e~~ /)~ fLl1o-tU ~1HV
1/
(Address) ~ Ar n\'-f'--
!f; f /-L2I2f /) iN
PID ;~5'-/):;'9~ 015'{)
-'
(Phone) ?5~-4J/1 -5 tf'<<1 ~1
Y!Jt L~U ;Z~ 0 I '112 fl _ ..5 ~ 3 "J,L.
APPLICANT '-I J / 1.1 .
(Name) <n ~ l#'-"~lJ 4--'L~..u
v
(Address) ,'3&.? D De~Q. L,6C,
(Address)
(Contact Person) -.lJ1 CL_, r-lJ :) i- /C'.v e Ail._~
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PPLICANT SIGNATURE lrYJl'lLJOf ~Q_LLt.t1....L'
- \I
(Phone) boi -J~6 --}...'3 'iD
~li:VU~)\ '-/lJ1? 5...'5/~a
(City) ..; (Zip Code)
(Phone) b51 -~~5 - j;j ~O
DATE P/d..o/a <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 Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink I Sewage Ejector
Shower Stall I Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink REQUEST FOR FINAL Lawn Sprinkler
Water Closet I INSPECTION SENT TO Other
HOMEOWNER 01-06
Industrial, Commercial & Multi-family I % or .100 <;U~l V\' au ~ ~~ _ ._ _
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $,.J (}-f) . Q-(:l-
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
, ~q. 5()
.50
4D.cr('l
(Office lise Only)
I This Application Becomes Your Building Permit When Approved
Building Official
Date
Recei1{/1'!.-)b
I Date ,Q-3G-QL( . ~\
cJ-
Paid lIU,.-
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
~.L/o.av
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
/
/
(
~
-----
SCHEDULED
1S-t-1L-
r(~ ~ /2 c:!-
DATE TIME
{{),]oU
q-R-77
o EXlGRADfFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
'WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~~';; ~ FOR REINSPECTION BEFORE COVERING
Inspector: !III (/ Owner/Contr:
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
!17-0 ftAALv
. ------.-------
,
/ ,
~ / D'7i
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-----~:::c
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
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CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEAL TH & SAFETY!
INSNOTI