HomeMy WebLinkAboutPlumbing Permit 03-1390
,
,
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
ItJ.1S":oJ
I, Blue File
2. Gold City
3. YellCIW Applicant
I PERMITNO'a3'_L3QO I
,
ZONING (office use)
(Please tv.IM:. or Dlint and sien at bottom)
I ADDRESS I 5 L\ 9.5
Rat Oo...lGD
Rd
LOT
LEGAL DESCRIPTION (office use only)
BLOCK
PID Z'5 ./4--4- . 0 0 1. 0
APPLICANT f'\ ' I . \ Al I c> ~ '""\
(NaJllP' lJ(}.\JI\.J.J\ \...A.J(CACi .( (Phone) lD I d. - DO I . vel iDO
La I LI .3 ~ A\ k OW k1.d{'J.'\_.l~ 56350
(Address) (City) (Zip Code)
(Contact Person) (J~ (Phone) SJ..MJ
/ - 'PLICANT SIGNATURE '" ~ ' - L J---. DATE 10- I' 03
APPLICANT P&~E COMPLETE BELOW
Type of Fixture - Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
I Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
I Bar Sink
I Water Closet (Toilet)
OWNER
(Name)
. (Address)
(Address)
Quantity
ADDITION
_l()~ GCt.Y
~
(phone)
968' 441-11,/
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
0t2. Residential, Additions & Alterations
Estimated Cost $ ?JI I to 0;;.-- Building Permit #
(Office Use Only)
,,-.
$99.50
$39.50
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ 3c{ ,5D
$ .50
$ YQdX}
iPaid #. vV
lDate
IO.I.r.o J
Receipt N~ 0/0
By --::r
U
"his Application Becomes Your Building Permit When Approved
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TlIIE
~~)
ADDRESS
/s~~..zs- ~ CJ.::~ ,1;1/
OWNER
CONTR.
PHONE NO.
PERMIT NO.
CJ..s - ~?fu
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
[J WATER HOOKUP
o SEWER HOOKUP
.,.9-1't.UMBING FINAL
o MECH FINAL
o EXlGRADlFILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMEN~~\'1. / I /J. _ / ..4 / (;)
n~.R>-- ~f!!A;'--.1'? /' -H;"....-
~,;L. .$r,,-h<.; 7~""'-
p/
..,-/
pee
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~~>~R REINSPECTlON BEFORE COVERING
Inspector. /~ OwnerlContr.
CALL ..7-8850 FOR THE NEXT INSPECTION 2A HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH I. SAFETYI
DGNOTI