HomeMy WebLinkAboutPlumbing Permit 04-0473
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File I PERMIT NO ,:b
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(Please tvD~ or Drillt and sim at bottom)
ADDRESS d- q d L.. (jO~ -r vOJJ.
I ZONING (office us,) I
LEGAL DESCRIPTION (office use only) r
LOT J~LOCK / ADDITION wA~ ~tf-
PIo':}s--3 Rd- ()/S- 0
OWNER
(Name)
8Aa. vOll\. G~-uJGv
.
S~
(Phone)
Cf6d- ~4 6-Cis,~
(Address)
APPLICANT
(Name)
(Contact Person)
We.d~
PPLlCANT SIGNATURE~ l ~\ DATE
APPLICANT PLEA~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)
()e.~ IkJ\.5
(JILl beD
(Address)
N\.I(\(l
wedql.
A~ ~lt ')
(Phone)
(Phone) 1.01 d - ~O 1- 5 d (06
Hu-~~ 55356
(City) (Zip Code)
!.J I d - ~{p 'i? -l.( L( 6~
5-13 -04
(Address)
Quantity
Type of Fixture
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
Estimated Cost $
Building Pennit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
:~q , 5D
.50
'-10,00
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
I Paid t;6;-- I ReceiP~t3 /
I Dat~ - eJD-041 By CJ
cr-
24 hour notice 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
q-;){) -0</
ADDRESS
2920
!3 0 {$ M?- 7J1.-.--C
OWNER
CONTR.
PHONE NO.
PERMIT NO.
4-,4-73
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
"t[FINAL
o SITE INSPECTION
COMMENTS:
o PLUMBING RI 0 EXlGRADIFILUNG
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RJ
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLINE AIR TST
( A 0 MECH FINAL ~ 0
('5{d-um ili~~
j
/J
L/
e,-t
0"
(- ~ 0
Ir l
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO'-:~ALL FOR REINSPECTION 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 4< SAFETYI
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