HomeMy WebLinkAboutPlumbing Permit #03-1513
CITY OF PRIOR LAKE PLUMBING PERMIt"
Date Rec'd
/(.,10.03
~. ~~ ~:~ PERMIT NO.O.?-/5/3
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS
/5295 WcOLJ OUM:- 7.7Z/1'/~ NvJ
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compa.lment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
iLL. I'
I7TJ; J f\ soy\.
b~
(Address)
APPLICANT
(Name)
(Address)
(Address)
(Contact Person)
o~ AfI~~1>n
APPLICANT SIGNATURE
Quantity
\./)
/'
I
ZONING (office use)
PID 25.]>B2. //("O
(Phone) 15~-~~~~~
(Phone)
(City)
(Phone)
(Zip Code)
DATE
JJ'-lfJ -0 'j
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 $
Building Permit # {) 7'- / ~ /?
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERl\111' FE]~ $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
::;r 9. 5-0
.50
4a (J])
Paid 4(}. C1J
Oat'll. If) .03
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., ]~rior Lake, MN 55372-1714
CITY O~ PRIOR LAKE
INSPECTION NOTICE
ADDRESS
15'2 crs-
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE TIllE
SCHEDULED ~ - (1---
~oeJL OVc..~ ~
CONTR.
PERMIT NO.
?- !)~.,
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
XG't~I~
, -)~: ~ r ~... ~ ( /
I J ." 'F /;. I 1)}.Y
\ / / l"
'--'
j
/
/WORK S ISFACTORY. PROCEED
o COR CT~T N AND PROCEED
o CO REC , CALL FOR R:EINSPECTION BEFORE COVERING
Ins 0 Owner/Contr:
r;; L.~~OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI