HomeMy WebLinkAboutPlumbing Permit #03-0974
CITY OF PRIOR LAKE PLUMBING PERMIT
,
Date Rec'd
(Please type or print and sign at bottom)
ADDRESS
l~L ~~:l;=' PERMIT NO. {)3-97f
d3,53 ~ p(Lbt
ZONING (office use)
LEGAL DESCRIPTION (office use only) ('"
LOT 3~LOCK I ADDITION J1;LeadovJ U ~
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(Address) '6 ct tJ ~,,~ /2A
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(Contact Person) ~ ~
uPLICANT SIGN:TURE ~~_W
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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
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
(Address)
;L3~3
Quantity
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
Estimated Cost $
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,0
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PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOT AL PERMIT FEE $
(Office Use Only)
~his Application Becomes Your Building Permit When Approved
Building Official
Date
PID.:2y.. 31$ Lf- {)3 lj-O
(Phone) q D'2. - 'flf! - 't06.Q.
)6 "5 -lIl 3 - /gq?
s57JJ/
(Zip Code)
~/2 - 38/J - ~ 7/9
7 -.:2- _~ -0}
(Phone)
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(City)
(Phone) d~
DATE
Type of Fixture
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
Building Permit #
.50
Paid t(O..---
Date7 _ ~3 -:5
ReceJfq'~~5
By fr
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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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DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED J:1! 3 /D3 J1~
ADDRESS IlJl!JI J?J53 ~y~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
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o FOOTING 0 PLUMBING RI 0 EXIGRADIFILLlNG
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
o FINAL 0 PLUMBING FINAL 0 GASLlNE AIR TST
o SITE INSPECTION 0 MECH FINAL 0
COMMENTS: '. ~ Y'/d~\&\A 'lMpU2V._
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~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
/fk-
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSNOTl