HomeMy WebLinkAboutPlg Permit 05-1030
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
I 0 . 14-, 0 S-
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 01-06
File
City
Applicant
PERMIT NO. 5: !fJ30
(Please type or print and sign at bottom)
, ADDRESS
/5dP?
,giflCk ~4,k, 12I,A!p_
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK
ADDITION
PID 2 5". :10+. 0 116 , ()
~~e~R .h1/,J(r~ /?R J 14,L.e- (Phonef'~~--:.h~._- ~ K":J-7
(Address) / s?J:J-Y-- /~3,! /^JL~/J:: ,/)///1.( ,;?rI ,I\/;e--
APPLICANT/) L) ) L" "7' --,'- . C
(Name) LI7 /t ny:/ MI .. I{ /?~ T"'~ ,(Phone) 9- ~'2.--ir ~ ~ <; 7fi.'/' /~ '"'._ ':J,"'1l
(Address) J ~M}/.? ~ / ,~ J-h M/ /)j'l /3.L,/f~/j 1st/ILLf" h//tJC;_> -.J___ r
, (Address) (City) (Zip Code)
(Contact Person) .~ ~j /';:/L r f .J~/.{-: ~/~. P (Phone) y C~ - Lj ,3 ~-7~ (~.:
JPLICANT SIGNA TURE P:/~ k~ h~j "'.I # A / DATE J // .- /. '7 .-"'G':- <).-
, -A~PLI~AN~ PL~~S~ ~~PLETE BELOW
Type of Fixture Quantity I Type of Fixture
Bath Tub with or without shower -....... Roug~
Dishwasher C ~ /- - tv'!. atefHeater -,
Floor Drain J -- Water Mnner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink , Sewage Ejector
Shower Stall I Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink ST FOR FINAL Lawn Sprinkler
Water Closet (Toih REQUE TO Other
INSPECTION SENT
Industrial, Commercial & Multi-family l' HOMEOWNER 10-06
Quantity
,__.dential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
3 If. 5V
, .50
'1"d . tJ ()
(Office Use Only)
'his Application Becomes Your Building Permit When Approved
Building Official
Date
Paid 10 -
DatJo J I f. ~ S""
Rece~ No. 8JJ /9
1. .
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
II eJO(.o
L
ADDRESS \::x:2~ ~ ~ R&
OWNER CONTR.
PHONE NO.
PERMIT NO.
5' - l030
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
J( PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
wrP!-\O't ~ffiier--
OK k C\b~ ~ \~\.,o
)i.WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CO CT ,ML FOR REINSPECTlON BEFORE COVERING
Insp ctor: , ~/.J Owner/Contr:
ALcl~85o FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
"-..-/
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl