HomeMy WebLinkAboutPlumbing Permit 04-0325
I
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
1-. V,O'/-
I. Blue File I PERMIT NO I
,. Go" c;~ . ~ 4- . 032..5
], Yellow Applicant
q>1ease ~ or nrint and siJ!Il at bottom)
ADDRESS ZONING (olllce"",) I
5930 ~t..Il'1L /'2.-foC-C 77l-<.-
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PIDZS. Zq,. 0/5. ()
. OWNER
(Name)
(phone)
(Address)
APPLICANT
(Name)
(Address)
~a/l PIcA.fVl6010
2-1131 )(e..oV1, A.IIP.)
(Address)
~.f
~..-r/
/lf~
(phone) '1S ~_ - 412- o>/:'l/-:
.Jordct>'\ (?5,?c;z..
(City) (Zip Code)
(phone) 6f Sz- - Zoo - :, I :7 q
4 /z.."'].../t>4-
DATE
(Contact Person)
,--. 'l.PPLICANT SIGNATURE
~
Quantity
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Qnantity
Bath Tub with or without shower
Dishwasher
I Floor Drain
I Lavatory (Bathroom Sink)
Laundry Tray (1 or 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
Type of Fixture
."
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
r-
(~
J
FEE SCHEDULE
Industrial, Commercial & Multi-family 1 % of job cost with a 539.50 minimum Resideotial, New One & Two-Family $99.50
Residential. Additions & Alterations 539.50
Estimated Cost $
Building Pennit #
()tf.()J2-.r
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
J 1. r1I
.50
q-o. vV
(Orne. Us. Only)
r This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid ,ft). () 0
Date 4-. z..~, 14'
ReceiptNo.~, 70
,
By
,f Iff..
f
I
-1
24 bour notice for all inspeetions (952) 447.9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372.1714
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE
1/!.4r-
07JCJ CZ--/~~ / ~'" ~
i/
TIllE
SCHEDULeD
ADDRESS
OWNER
PHONE NO.
CONTR.
PERMIT NO.
#-.32.r:;-
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
....ef!S'LUIIBING ANAL
o MECH ANAL
o EXlGRADlFIWNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASUNE AIR TST
o
COMMEN.J:&1 r /J /
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7
" WORK SATISFACTORY. PROCEED
I'b CORRECT ACnON AND PROCEED
o CORRECT WO~ REINSPECTlON BEFORE COVERING
Inspector. P",/-- OwnerlContr.
CALL "7.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUlREMENTSAlIE FOR YOUR PERSONAL HIULTH & SAFETY!
IIGNOn