HomeMy WebLinkAboutPlumbing Permit 04-0799
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
7.Z,'f,04-
,Please tvDe or Drint and sim at bottom)
. ADDRESS
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LEGAL DESCRIPTION (office use ooly)
LOl$(J BLOCK ( ADDITION
WI '-'OJ .J (J <J17f'
OWNER
(Name) .I
(Address)
APPLICAN1;--, . ,"I ,
(Nam,i j.JJ/'a 3-x !)JJ;VI
(Address) 'i$2!'\' /']!L;leY' )/t?/~j,fr
(Address) V .
(Coo""_o) Q';:1"-<
APPLICANT SIGNATURE ~--
;~: ~:~ I PERMIT NO.O+. 0'7~ I
3. Yellow Applicant f -,-,
ZONING (office use)
pm ZS-. ~8 z... (J.70. 0
(Phone)
(Phone) 0 s-/- 4/.s- 0 '1' CJ Y 2
W~./ TGif I1n S-S-O/{;
/ (City) (Zip Code)
(PhOne}~S-/-~)O 79L/ 2-
DATE 7-27-04/
Quantity
APPLICANT PLEASE COMPLETE BELOW
Quantity
Type of Fixture
Type of Fixture
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (1 or 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
x
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
LawnSprinklerJHsTqll J '. r..J///(
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 $ BuildingPermit# 64. om
PLUMBING PERMIT FEE $. ~? 9 '5.9--
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $ Ljr)~
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid
'fO,C/l)
Date A ,
7.JO,a.,-
ReceiP~ NO."""7 5'7"
By.A'.
i7
24 hour notiee for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
>? -;!.o '0 <./
I
ADDRESS
30 I (p B 0 f5 eA r- 77U.....-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
4-. 799
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
)!fFINAL
o SITE INSPECTION
COMMENTS:
o PLUMBING Rl 0 EXIGRADIFILLING
o MECH Rl 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLINE AIR TST
( .A 0 MECH FINAL ~ 0
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V
oS L
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/7
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~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~'Q:.ALL FOR REINSPECTlON BEFORE COVERING
Inspector. -<JAJ.-., OwnerlContr.
/ r
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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