HomeMy WebLinkAboutPlumbing Permit 04-0741
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS ~~ <e
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED
n - ~J2__
...-~T~
CONTR.
PERMIT NO.
d -7c.{1
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
~~
(WORK SATISFACTORY, PROCEED
/0 CORRECT ACTION AND PROCEED
o CORRECT K, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CAL -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
~
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
OWNER 2 tVl,'
(Name) ... ~W p-d k .. I-fe;i 01
(Address) 288ft:, CuuQAAJr -Prd;h
V
APPLICANT ~ \ \_ \ _ \'). )
(Name) I\J(J(D\O'M rlUMl\b,^~ (Phone) (~,z., '827- '/()33
(Address) 2905 Cl~e/cJ AY~.~. M")I~ -$So/O'8
(Address) (City) (Zip Code)
(Contact Person) l1-n1y or PaM! (phone) Jlo/zlJ?27-t/033
'PPLICANT SIGNATURE ~ DATE 7 Ii' ~'1
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compallluent sink
Shower Stall
Sinks
Bar Sink
. Water Closet (Toilet)
(Please type or print and sign at bottom)
ADDRESS
2 ~8 ~ ~(jcvr- A.:th
LEGAL DESCRIPTION (office use only)
LOT 4 BLOCK 3 ADDITION W..JYdo 71 02t:t..-
Quantity
!
1. 1,1. 04--
I. Blue File PERMIT NO
; ~~:~w ~~~Iicant · () 4-~ b 14-/
ZONING (office use)
PID zs: 4<J ~. 037. 0
(Phone) I'S'z.~ -at/Ot(
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 Permit # 04-. 07'1-1
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERNlll. FEE $
(Office Use Only)
,I This Application Becomes Your Building Permit When Approved
Building Official
Date
.~,. 5rJ
.50
~() .~ 0
Paid A~
~O J 0 0
Date
7. Z,I. o+-
Recei~7'Z9.3
BY~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714