HomeMy WebLinkAboutPlg Permit 06-0595
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 10-06
APPLICANT ., f 1.1 7'1 I
(Name) N(J(p Din rTVUIt tJ~
(Address) 2- q 05 0)2,1) el rl ~ e S fl1 pi '7
(Address) (City)
(ContactPe"on) (Xii 11 ~ ~ .. (phone)
APPLICANT SIGNATURE ~~ DATE
- APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
I Floor Drain
I Lavatory (Bathroom Sink)
I Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
I Bar Sink
I Water Closet (Toilet)
(Please type or print and si2ll at bottom)
ADDRESS
lYgee 'P1~1-e 'Pa/lIlr CIYtlc:
LEGAL DESCRIPTION (office use only)
LOT ~LOCK (' ADDITION
Fe!!oAJ~
OWNER
(Name)
LI O'ft:..
Se~vtc~5
(Address)
.c;~M P _
Quantity
Blue File
Gold City
Yellow Applicant
I PERMITNO'00-,~q~r
SOvtl" C?!j-t-
ZONING (office use) I
) S-t-
PID I Cf(). OJJ-
(Phone)
<-ILl/) - ASs9
(Phone)
5<>'-1 0 ~
(Zip Code)
OG --2. ~-{;~
Type of Fixture
J
I
Rough-ins
I Water Heater
I Water Softner
I Stand Pipe (Washing Machine)
I Sewage Ejector
I Backflow Assembly
Backflow Assembly Test
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 $
L/ IJ/)aJ
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOT AL PERMIT FEE $
(Office lJse Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
50
~
.50
C)O cD-
Paid
t.;e -
Date 7- '3--6
Recei~'7 &.D
By UJ
<./~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S,E., Prior Lake, MN 55372-1714
SCHEDULED ;;:I~TIME
/ 7'7'~cr ~~/ e ~ C/~ L
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
6 ~-S~-7?_r'-
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
~MBING FINAL
~ECH FINAL
cOMMJtlns: .. I . I I / /
/4PC Vie e d Ck~i Tt'/ ffic~Te'-
, / --I- ~v-/? C/ c -0
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03~74/(~ hilh
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/- /P'!~
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o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
cJ/
"
~ATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CA~SPECTION BEFORE COVERING
Inspector: d~ Owner/Contr:
v
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!