HomeMy WebLinkAboutPlumbing Permit 04-0068
CITY OF PRIOR LAKE PLUMBING PERMIt'
Date Rec'd
\l'lease type or print and sign at bottom)
ADDRESS
3505 134,-/ ~110 It s 'Dr,
?GIli DE'fL;;TJf~ffice use only)
LO~ OBLOCK I ADDITIONI*~ /&f-
OWNER \...., I
(Name) U4V~~/l L4~
(Address) 8~ A-:::5 ~loo~
(Contact Person) "
APPLICANT SIGNATURE ~ ~
( ~ ~/
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)
APPLICANT
(Name)
(Address)
Quantity
~".i""., ,,:. :'''''':'; \ ~ ,,,,,1 '; l ie:; ~:;.:,
r.;'~}':"U CuU H:t ',i-.\ "\::" -,1'
M/NNETONK;\'t MN 5,:I~:)4S
{(;r:,~)) O';t~ '''7nC'ff
(Address) , ".. ','"
I. Blue File PERMIT NO. ()t(~ --6P'
2. Gold City __,
3. Yellow Applicant
.s:i37~
ZONING (office use)
~ f~SJ)
PID d5 - 8 !JO- (XJ J....:.7:J
(Phone)
(Phone)
( City)
(Zip Code)
(Phone)
/ /z3/ () V
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
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
(Office Use Only)
Estimated Cost $ -..ii/1)o --
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PEAA... FEE $
This Application Becomes Your Building Permit When Approved
r-
Building Omcial
Date
'39. ~
.50
~O{OCJ
Paid </iJ,,""""'-
Date~_17-0L(
Rece~~ 8 ~ S'-
BY~
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
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
'1~
(1.y' ~~r;.
I' .
CONTR.
OWNER
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
DATE nilE
/- ;2y~
. I.
I04-~ 00&'1'
o PLUMBING RI 0 EXIGRADlFILUNG
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASUNE AIR TST
o MECH FINAL 0
.f~1-O >~
COMMENTS:
~
(/ j/' /() ')f:..
\ ~~ '-' -
"
~
.~
r.
, /
r ' LP
\
--------
.A
/rl' (.
r?l#"
\
dRK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT A~L FOR REINSPECTION BEFORE COVERING
Inspector: r Vf" Owner/Contr:
CALL 447-9850 FO~ THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
I1ISNOTl