HomeMy WebLinkAboutPlumbing Permit 04-0570
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
APPLICANT.. \ L I ~ L
(Name) NO('OlCJ\'Y\ rlUAN\D~
(Address) 2<tO ~ UJ04J;" k/ Av'L ~".
(Address)
(Contact Person) ~>I
'PLICANT SIGNATURE O~ ~~ "" -
~-- J
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
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)
(Please type or print and sign at bottom)
ADDRESS
/5//'5'
J-e{{~s. RS5
LEGAL DESCRIPTION (office use only)
LOT/... BLOCK, ~ ADDITION
.,...
(11/wt/.1 k#
1/1XJ
. OWNER'i::> J.
(Name) l-,rO'l.lJ ('I ! 1M
(Address) ISII~ , )4!..ff~ 'H-S5
Quantity
FEE SCHEDULE
Industrial, Commercial & Multi-family 1 % of job cost with a $39.50 minimum
Estimated Cost $
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
'his Application Becomes Y onr Building Permit When Approved
Building Official
Date
\, Blue File
2. Gold City
3, Yellow Applicant
I PERMIT NO. Ol!~,l)74>
ZONING (office use)
PID~5-3q5- O~--O
(Phone)
(Phone)
((oIZ) 827-'1033
~S'l(}i
(Zip Code)
Mols
(Cily)
(Phone)
M,.. tnl.tL
DAT~' f:> hE Jd9
Type of Fixture
I
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
Residential, New One & Two+Family $99.50
Residential, Additions & Alterations $39.50
Building Permit #
3'9,S7)
.50
'/O,(jO
I Paid L/CJ ----
I Date it. .
F'" /0- C-/
RecetlPoog to {
By C1 1
V~
24 hour notice ror all inspections (952) 447-9850, rax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
c;?-db-O(j
I
ADDRESS
/ S / I g ~TE:P~EIGS ,P-1SS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
4-. 570
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
)If FINAL
o SITE INSPECTION
COMMENTS:
o PLUMBING RI 0 EXIGRADIFILUNG
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLlNE AIR TST
( .A 0 MECH FINAL ~ 0
(/idum iliIYU/'rtJ!JJ/V
j
/)
V
c..L
0"
(-l ~
Ir l
~ORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector. ~ OWner/Contr.
I I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETY!
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