HomeMy WebLinkAboutPlg Permit 03-1052
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
APPLIC~ ' .
(Name)~Jt (\~\~ \h' IP11 4='1' P)). 'C'tj-PP (phone) L 'tS-t:>?lJl-~1
(Address),C)i?' Qtw ~ A. ~ 1.D'4 #ll~\ LDt tJ-fDllo
- (Ad~ss) (City) (Zip Code)
(Contact Person) Ul (-y--,. _ . ) (Phone)
r"PLICANT SIGNATURE {1iv~~ DATE ?cl S-IOO
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APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Showel
Sinks. REQUEST FOR FINAL
Bar Sm
Water ( INSPECTION SENT TO
HOMEOWNER 01-05
ll'EE SCh.J!.JJULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
REQUEST FOR INSPECTION
SENT TO HOMEOWNER.
FEB. 2004
(Please type or print and sian at bottom)
. ADDRESS
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LEGAL DESCRIr uON (office use only)
LOT I BLOCK '- ADDITION~ IIJM
OWNER"- _
(Name) , NJf\
(Address) \.It l:) 5 \
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Quantity
I. Blue File
L Gold City
I. Yellow Applicant
f);:{\
PERMIT NO. ~3 " t65:J....
ZONING (office use)
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(Phone)C\sd-liLl5-~q~
Type of Fixture
I
I
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Pennit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Offiee Use Only)
( "l'his Application Becomes Your Building Permit When Approved . Paid
-~ D~
Building Omcial
Date
<,-=3q. 5tJ
.50
l./tJ ,DlJ
lIf:) ',---- . Receipt 7)"350~
j' ~':? By Y..---
u
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
2.11.010
ADDRESS
1455/ WtL.-OS vlbW
OWNER
CONTR.
PHONE NO.
PERMIT NO.
3.1052-
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH Rl
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
SENT TWO REQIJ-ES-TS FOR
INSpEL'llON LETTERS uur-
-RECEIV:F.D NQRESPo.NSF.
CLGSE-FILE DYE ro
INACTIVITY
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
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