HomeMy WebLinkAboutPlumbing Permit 03-1182
DATE nME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED /O'/.p~
ADDRESS ~~1 CVl.~_>(,V\4-rI {~
OWNER CONTR.
PHONE NO. PERMIT NO. 7. -/ / >r'2.
o FOOTING o PLUMBING RI o EX/GRAD/FILLlNG
o FOUNDATION D MECH RI D COMPLAINT
D FRAMING D WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL o GASLlNE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS: C:;/l ,.. t '1 It., fA"
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~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~RK~FOR REINSPECTION BEFORE COVERING
Inspector: Y V O~ Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSNOn
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
~;;~~ANT tJ~ \.JJedev- (Phone) LP\ ;) - 8'0\-- 5J loO
(Address) tj, 14 (~@ 1-\v'it fit \ \-\u..-~ 5535D
(Address) (City) (Zip Code)
(Contact Person) ~ (Phone) ~
.---APPLlCANTSIGNATURE ~ ~jt--- DATE q-"Z. D~
APPLICANT PLEA~ COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
I Lavatory (Bathroom Sink)
I Laundry Tray (lor 2 compartment sink
I Shower Stall
I Sinks
I Bar Sink
I Water Closet (Toilet)
(Please type or print and si~ at bottom)
ADDRESS _l
55lo I CY~OJAO~ S\-vt.~t
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER . 1 /
(Name) .Jne.. : ~o...,^-, 'At:... Mes'-\v\\ (J,
(Address) ~
Quantity
,
'1+-0.1
I. Blue File
2. Gold City
3. Yellow Applicant
PERMIT NO,Cl! - / / ez-
ZONING (office use)
PID 2l)_3ol. ,071 . b
(Phone) q5a-J;).iP -44\PU
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
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 $
lll~
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
J This Application Becomes Your Building Permit When Approved
Building Official
Date
39,5D
.50
'-\0.00
Paid 4- (). 00
Dat~ 5. () J
ReceiP~Z 7 f
By /.
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
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