HomeMy WebLinkAboutPlumbing Permit 04-0375
CITY 01 PRIOR LAKE PLUMBING PERMIT
Date Rec'd
~. ~";: ~!~ I PERMIT NO. /V i_ Q ~ a--
). V,lIow Applicant U'-t ......::> ~
(Please.!V2C:. or Drint and sie at bottom)
ADDRESS ZONING (ollie< use)
OWNER
(Name) m(/~ nU~
(Address) S'SI'i ~,(b.N',4,AJ1)R'" d'7". / PA?/oA!? t."..ez
~;;~fANT A'1I.ee 51!)L ~8' 1f;l1'j (phone) 95.:/- Pf~-U~OI
(Address) /.2'169 Z~,u,f?H~ AI/~ cr.Nt/A'~ 5S"3").P
(Address) (City) (Zip Code)
(Contact Person) C ,4,(1 t..
S-S/ "
e~o.!5A~I)~,4 .5'7'".
LEGAL DESCRIPTION (office we only)
LOT J, BLOCK 5 ADDITION
1~a1 iJ~9-'arJ
()
(phone)
PIDdS- ::Si')~" "Dt.!7 -D
q5'.l-~Y7-RI,r
r 'A.PPLICANT SIGNATURE
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(phone)
,5AI'1.L.
DATE yh"'/....,......
APPLICANT PLEASE COMPLETE BELOW
I Type of Fixture Quantity I
Bath Tub with or without shower Rough-ins
I Dishwasher I Water Heater
I Floor Drain I Water Softner
I Lavatory (Bathroom Sink) I Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 compartment sink I Sewage Ejector
Shower Stall I Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink / I Lawn Sprinkler
. Water Closet (Toilet) I Other
Quantity
Type of Fixture
FEE SCHEDULE
Industrial. Commercial & Multi-family 1 % of job cost with a 539,'0 minimum Residential. New One & Two-Family 599.'0
Residential, Additions & Alleralions 539.'0
Estimated Cost $
Building Penn it #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.:19.5"0
.50
~O"-
(omce Us. Only) .
r This Application Becomes Your Building Permit When Approved
I Paid 9'0 -
I Date !;. 3- t.j
Bulldln. Official
Dlte
24 bour nollce Cor all Inspeetlons (9'2) 447-9850, en (~52) 447-4245
16200 Eagle Cr..kAv... S.E., Prior Lake, MN 55372-1714
Rect9~~
By
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J
ADDRESS
.s:s-/9
DATE TillE
SCHEDULED ~.-
I'/O-IT4~ ct-4 S I-
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
~--?7S-
IJ FOOTING IJ PLUMBING RI IJ EXlGRADlFILUNG
IJ FOUNDATION IJ MECH RI 0 COMPLAINT
IJ FRAMING IJ WATER HOOKUP IJ FIREPLACE RI
IJ INSULATION IJ SEWER HOOKUP 0 FIREPLACE FINAL
IJ FINAL .,.l!f15lUMBING FINAL 0 GASUNE AIR TST
IJ SITE INSPECTION IJ MECH FINAL 0 _
COMME~: I /)/ 4. f' ()
/~C 1'- H"''''--' /"?'eva-t7?<.. 7>:>';/
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~RKSATlSFACTORy,PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~ ~~F~REINSPECTlON BEFORE COVERING
Inspector. ~y OwnerlContr.
CALL "7.9850 FOR THE NEXT INSPECTION U HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SltFETYI
IN_'"