HomeMy WebLinkAboutPlumbing Permit 04-0640
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
~fc . tJ.04---
--.
q'lea.se tvJ>c:. or orint and sim at bottom)
ADDRESS 2... \ cJ '2 \ \ r .
u \ 1J::.J \ '(Y\ ~ \;)) t\- ~xrJ (J ,
;:: ~:~ I PERMIT NO. 04-.0,,41) I
3. Yellow Applicant
I ZONING(offioeuse)
LEGAL DESCRIPTION (ollice use only)
LOTJ9BLOCK (ADDITION ;V(){JoS @ ~ kJ/c...Of
PID z.5: 3'83 . 0::3 9. 0
~~p~R C"hr', S \fur YUL{
(Address) ~ \1.?J ~ ~ ~ \ l-."n ~ (';,(' (~\ 0
~;;~~A~ Vro cV\~~X\(\~~n.Q (Phone) 9~d' 4&l\ . (ljqcr I
(Address) ~ \L\C\ t\;qhlhtl0 (.\\~(JLDJ< Q rll'/Iu. mtJ ~p
(Address) . (City) (Zip Code)
(contactPerso~) ~f\'4 ~\]\\J (Phone) eNS;), 41ll' &qqq
\PPLICANTSIGNATURE ~~"\..},. ~ ~ ') DATE \0. 61- ot-(
~ ~
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
I Laundry Tray (lor 2 compartment sink
I Shower Stall
I Sinks
I Bar Sink
I Water Closet (Toilet)
(Phone)95~. ~a[p .aVJre~'
Quantity
Type of Fixture
Rough- ins
Water Heater
I Water Softner
I Stand Pipe (Washing Machine)
I Sewage Ejector
I Backflow Assembly
I Backflow Assembly Test
I Lawn Sprinkler
I 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 # tJ 4'. 0 ~ 40
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
'2., l' SO
- .50
LJD v.=S '"
(Office Use Only)
I
This Application Becomes Your Building Permit Wheu Approved
Building Official
Date
I Paid #, ov
I Dat&. Z3. (}4--
::c",04 72-20'-
J'
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
OA TE TIME
[?- :J. 0 -() tj
ADDRESS
3/83
TI /"1 L:Ii3Jud Q(...,c
OWNER
CONTR.
PHONE NO.
PERMIT NO.
4- ,~40
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
It' FINAL
II: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 GASLlNE AIR TST
o
S J).A.. Vl- h On -<--
COMMENTS:
!- CLwJ1
\ f ~ \-1/
11 l)// -
(/, y\
~ORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRElECWOR CALL FOR REINSPECTION BEFORE COVERING
Inspector. Owner/Contr:
CALL 7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS Al/E FOR YOUR PERSONAL HEALTH .{ SAFETY/
uaNOn