HomeMy WebLinkAboutPlumbing Permit 04-0806
DATE TIME
CITY OF PRIOR LAKE g{(~
INSPECTION NOTICE SCHEDULED
ADDRESS ~ '7-i.oL B.'~
OWNER CONTR.
PHONE NO. PERMIT NO. '"' - eOc,
o FOOTING o PLUMBING RI o EXIGRADIFILLlNG
o FOUNDATION o MECH RI o COMPLAINT
D FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL o GASLlNEAIR TS~
o SITE INSPECTION o MECH FINAL .Y~
COMMENTS:
/'
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRElT W K, CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CAL ~o FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODJlREQUlRE)fENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec' d
1. 2-.. 0 f"
~: ~~~ ~!~ ' PERMIT NO./\/l.. 0 Q() 1_
3, Yellow Applicant V, () fP
,-"lease type or print and sit'l at bottom}
ADDRESS ZONING (office use)
/~~eo 17{.,1/~d'//U::) 'f~
LEGAL DESCRIPTION (office use only)
LOT 0BLOc0 ADDITION */"</l/tJb
'''\,
fldi
OWNER
(Name)
(Address)
APPLICANT /J \ t __ ' \) \
(Name) /--1- C-L Y'~~, ~ ~ ,. J t1
~ , ~ g' ,
(Address) ~J... 7 b 0 '4 ~ -c \' y, 0) \ 1
(Address)
\'0 ~
(Contact Person) " , 1
APPLICANTSIGNATURE ~~;:,~
PID Zs. $10 r 0 zz" (J
(Phone)
(Phone) / s-' L ~ ~ ()-t} 0 0 ()
L~ R~ ~ ',\)", . S-~oL/ 1
(City) (Zip Code) f
(Phone) lJ) <." ~--"' I -'$ J7 <;
DATE ~00 ~
APPLICANT PLEASE COMPLETE BELOW
Quantity I Type of Fixture I Quantity I Type of Fixture
Bath Tub with or without shower i I Rough-ins
Dishwasher i I Water Heater
Floor Drain .i I Water Softner
Lavatory (Bathroom Sink) i I Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink.i I Sewage Ejector
Shower Stall i ~Backflow Assembly
Sinks i V'" I Backflow Assembly Test
Bar Sink I I Lawn Sprinkler
Water Closet (Toilet) I I Other
FEE SCHEDULE
Industrial, Commercial & Multi-family I % of job cost with a $39.50 minimum
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Building Permit # 0 ~. rJ r'O ft:,
Estimated Cost $
(Office Use Only)
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERl\tn 1 FEE $
This Application Becomes Your Building Permit When Approved
Building Official
Date
;r f., J(J
,50
9V r L-O
Paid /L-,
'rO ~ t/V
Dater ~
. (". d .,
ReceiPt~O.I-'1r1/
;to
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S,E., Prior Lake, MN 55372-1714