HomeMy WebLinkAboutPlumbing Permit 03-0864
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Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File
2. Gold City
3_ Yellow Applicant
I PERMIT NO. 03-' 'cf ~ 1
q:'lease ~ or orint and sign at bottom)
ADDRESS 5831 C v~~ 6\.Ir.
ZONING (office use)
~ Kf~dJfU /51-
I-\f'C-tov LDffi"Z...
$JJV\J
~;;~~ANT t)~ \Npcbt (Phone) _ lplri-8[)\-5dtoO
lol4 3~ A\ ~ 8b \-lu-~ 5536D
(Address) (City)
(Contact Person) t\~ (Phone)
(- 'PLICANT SIGNATURE ~ \.;Jx--- DATE
APPLICANT PLEAS~OMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
LEGAL DESCRIPTION (office use only)
LOT;>}aLOCK 3 ADDITION
PID~"" ;::)1q..../)S3,:;
OWNER
(Name)
(Phone)~' 4QD-468<1'
(Address)
(Address)
(Zip Code)
lo I rl - 8:D \ - (:g{d)
Quantity
Type of Fixture
\
Rough-ins
Water Healer
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
I 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
00
Estimated Cost $ 12l'P-
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
~
.50
40.LD
~mce Use Only)
'his Application Becomes Your Building Permit When Approved
Building OIDcial
Date
I Paid L(o .:-
IDate 7-1><3
RecerJLi ~ t3 5 I
BY~ I
~ ,r
\->
24 hour ootice Cor all inspections (952) 447-9850, Ca. (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
o EXlGRADlFILLING
D COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GASLINE AIR TST
D
COMMENT.s1 /lj1/ /J /
L/~C,{L~'::fJ /';<eu-e.... '1('''''
L~h Jr-r14- 'ft~
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS --,<::,X'..s7 r5.~4'iti.::.
OWNER
PHONE NO.
CONTR.
PERMIT NO.
o FOOTING
D FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
D MECH RI
o WATER HOOKUP
o ~R HOOKUP
.,..g-1'LUMBING FINAL
o MECH FINAL
&~
DATE
/A~-
.
S-/
TIME
t::)s-R6~
()
;l-c::J/
~KSATlSFACTORy,PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~'~~')FO~EINSPECTlON BEFORE COVERING
Inspector: r~ OwnerlContr:
,
CALL "7-1850 FOR THE NEXT INSPECTION 2. HOURS IN ADVANCE.
INSNOTl
CODE REQUlREMENrS ARE FOR YOUR PERSONAL HEIlLTH .. SAFETYI