HomeMy WebLinkAboutPlg Permit 05-0177
Date Rec'd
(Please type or print and sign at bottom)
ADDRESS '5 '375 N E"
CITY OF PRIOR LAKE PLUMBING PERMIT
REQUEST '{ FINAL
INSPECTILJi\J SENT TO
HOMEOWNER 01-06
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File
City
lW Applicant
I PERMIT NO. 0_0-. (1 r7 7 I
ZONING (office use)
(2../
LEGAL DESCRIPTION (office use only)
LOT (p BLOCK
ADDITION j./(,.L171 JI1l'rL.c';: i!/'/11-J (Jr'
PID ;;:S, uroft;. CO c" 0
~~e~R , luLtnl ta ,J oneS
(Address) ,<) Am ~ Pr l b I--
(Phone) q 5'2 'f4? 8' '3 joS-
Le^- j(L, M N 563'72.
APPLICANT. (.)
(Name) +-lPr-lpf_wor-KS
(Address) --2J.J1 D DlXld J-2d
(Address)
(Contact Person)
kJr/5 ().~
, . {(.lfA. '~
PPLICANTSTGNATURE LJ~.
JI
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity I
Bath Tub with or without shower I Rough-ins
Dishwasher I Water Heater
Floor Drain I Water Softner
Lavatory (Bathroom Sink) L I Stand Pipe (Washing Machine)
Laundry Tray (I r ' FOR FIN A I Sewage Ejector
Shower Stall REQUEST N SENT TO Backflow Assembly
Sinks INSPECTIO 10-06 Backflow Assembly Test
Bar Sink l\.ilEOWNER Lawn Sprinkler
Water Closet (Toil IlOl.'U I Other
(Phone) pC:;/3b512>40
EtlC-fan 6"512 '3
(city) (Zip Code)
(Phone) _~t.LfY\ e."
DATE 3/4/05
I
Quantity
Type of Fixture
FEE SCHEDULE
Industrial, Commercial & Multi-family 1 % of job cost with a $39.50 minimum Rcsidcntial, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $ 'lC1J .00
Building Permit # () 5. (1/7 7
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOT AL PERMIT FEE $
3Cj · t)()
.50
111- nr)
(Office lise Only)
Buildinl: Official
Date
Paid. L..:? )
/Tu , (/(.,
Date
. J.. tJ. {If
Receipt No. 6/" '7
4-(/1:'4" ~/
By
/dil
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
10. aD /ID
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
(, '7 7'"
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f
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
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DATE TIME
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o EXlGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
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C;'J
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; WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CA~ REINSPECTION BEFORE COVERING
Inspector: ,'M Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!