HomeMy WebLinkAboutPlg Permit 04-0432
REQUEST FOR FINAL
INSPECTION SENT TO
. HOMEOWNER 01-05
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(Pleasetvtle or print and siltDat b~~~__)
ADDRESS
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LEGAL DESCRIPTION (office use only)
LOT 1 BLOCK I ADDITION
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Beanl
ZONING (office use)
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OWNER ~ //1 '_ AAAA_'1
(Name) ..,~.rv
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(Phone/?5~-.l./9lJ "'- 'l(}L/-I
(Address)
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
Shower Stall
Sinks
Bar Sink : REQUEST FOR FINAL
. Water Closet (Toi~ INSPECTION SENT TO
HOMEOWNER 01-06
Industrial, Commercial & Multi-family I70 01 JVV w~. .. m_ - .
~;;~~ANTW fJ (J~~~
(Address) ~?tJ J;)~ ~ ~/lAAnJ
(Address) ',- - - -
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I!J~~ WJ)lI~~.J
(Contact Person)
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PPLICANT SIGNATURE
Quantity
(phone) ~bl-3~6 -}3 ~
411/L ~ 1J:5L4. =?
(City) (Zip Code)
(Phone) _ ~
DATE .t/ -~ ') -- tJ~
Type of Fixture
I
Rough..ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
:sidential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $ ~b-t' _ otJ-
Building Permit # 0 ~. () HZ-
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
~
. This Application Becomes Your Building Permit When Approved
Building ornclal
Date
.:3 C/. 5 ()
.50
-s/ tJ ~ 0-0-
Paid
.40,00
Date
So /3. () 4-
ReceiP~ N04 If z..fp
B:L.
U
24 hour Dotlce for all iDSpectiODS (952) 447-9850, fax (951) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
z ,[7,0"
ADDRESS
{floG I (;\I65r AVe:-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
4 ,432-
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING Rl
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXJGRAD/FILLlNG
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
-sENT
TN~PEC.llQN LETI'ERS UUrl'
-REGEIVED-NO
CL6Sb FILE-DBE T8
o WORK SA TIS FACTORY, 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!
JJ<SNOTI