HomeMy WebLinkAboutPlumbing Permit 04-0801
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
7. z9. 04-
; :,; ~::y I PERMIT NO'04-, 00.01 I
3. Yellow Applicant CI
ease typ~ or print and sign at bottom)
ADDRESS 150Q l/ utffe rs pass N VV
Wa4n~r
0;!-fff'IS pass
~;;~~ANT Nor I:J / om P [urn bin q
~05 f:;Jar-f1eLd /tV. "00.
(Address)
(Contact Person) Am. fA
APPLICANT SIGNATURE --3~
/ I
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture I Quautity Type of Fixture I
Bath Tub with or without shower _ Rough-ins 1
Dishwasher I'/~ Water Heater I
Floor Drain Water Softner I
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine) I
Laundry Tray (lor 2 compartment sink Sewage Ejector I
Shower Stall ( Backflow Assembly I
Sinks Backflow Assembly Test I
Bar Sink Lawn Sprinkler I
Water Closet (Toilet) Other I
()1~ baa-r{(JYY -for sprUlkltr stir.
FEE SCHEDULE V
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
Building Penn it # O+-.oBaJ
50
Y1. -
.50
/..If). vy
LEGAL DESCRIPTION (office use only)
LOT +- BLOCK 3' ADDITION ~G/e..f 1',
OWNER
(Name)
TLiCJl-
I ~Dq [p
(Address)
(Address)
Quantity
Estimated Cost $
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
J This Application Becomes Your Buildiug Permit When Approved
Building Official
Date
ZONING (office use)
PID 25. 3&(5. 05G.. 0
(Phone)
NW
(Phone) (&/1,) rt1-40?~
J (yrn/<:;- 5S40g
(City) . r- (Zip Code)
(Phone) (~('J.) g~1r40?;;3
DATE 7/ /5/ DLt
$
$
$
r pai~. CI()
I Date /,30, 64-
Receipt +7!j,7 fr'
By /[.,
()
24 hour notice for an 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
OA TE TIME
.f?- :J, 0 -() tJ
ADDRESS
/.t:J09t:- J6;::;PEIeJ A':JSS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
-1-, eo/
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
il" FINAL
I1:J SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASUNE AIR TST
,0
S,OA. vr-kf2rv..--
COMMENTS:
i CUUJ1
\ / f.,; \.1/
(1 lY (\ '-
~' y
~RK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~~. CALL FOR REINSPECTION BEFORE COVERING
Inspector. rn V' Owner/Contr.
CALL ~-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH 4 SAFETY!
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