HomeMy WebLinkAboutPlg Permit 05-0402
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 01-06
(Please type or print and si~ at bottom)
ADDRESS
J foOfo2 C~- Or. f,. E.
LEGAL DESCRIPTION (office use only)
LOT BLOCK
ADDITION
PID Z.~ DC) Cj . 0 (.3. 0
OWNER .tC.. _, . . \ I A _ _ r ,
(Name) (' ~, r\ r-" Y\OellO.
(Address) J fd2foz (' A.u1br ;aI&/Z.. CJr. /5,.6.
APPLICANT l \ b D
(Name) ~r \0\t\A rtl.MMbft] (Phone)J.~12)Y27-t.J~11
(Address) 2!3tJS- c,,/JA".he/cJ Ave. ~~. /v1,1)I.s5"!>,/~g
(Address) (6ty) (Zip Code)
(Contact Person) ~yl t>Y fJ:,.d / (Phone) (&;'2) K 27 - ~/) 3 3
APPLICANTSIGNATU~ ~--;?---%- DATE #21.J~~
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture I Quantity
Bath Tub with or without shower I
I Dishwasher I
Floor Drain I
Lavatory (Bathroom Sink) I
Laundry Tray (1 -
I Shower Stall REQUEST FOR FINAL
I Sinks
I Bar Sink INSPECTION SENT TO
I Water Closet (1 HOMEOWNER 10-06
Quantity
I
/-"- -. ("~
~--. . L.":J . C J
~i~ I PERMIT NO. 05. (.1 4-02-
1/ Applicant
ZONING (office use)
(Phone)
('l5z\41IJ-/7tJ 3
Type of Fixture
Rough-ins
I Water Heater
I Water Softner
I Stand Pipe (Washing Machine)
I Sewage Ejector
I Backflow Assembly
I Backflow Assembly Test
I Lawn Sprinkler
I 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 # ~)5-, 0+02..
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOT AL PERMIT FEE $
(Office lJse Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
31. Sl>
.50
J/().OO
Paid. ;t.J
4-0, (
Date_ / L
::; . if (/~
Receipt NO/4/'7 Y
By jfH
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
/(;1 oc J...
. ,
(,;vV17'1~-h,~
.. ,. -
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULA liON
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
1-1- ~ ilh-
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/1" / f)C:;/ rl It
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COMMENTS:
tiJ- 0
,
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----- -~
DATE TIME
I!-t-/-c-{;
5-:: Cf () 2....
,/
//-
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'WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT VYO"Rt(. C..pAL,1,.. REINSPECTION BEFORE COVERING
il J /J/
Inspector: / / ./ Owner/Contr:
. V
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
lNSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl