HomeMy WebLinkAboutPlumbing Permit 04-0474
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
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LEGAL DESCRIPTION (office use only)
LOT q BLOCK ~ ADDITION / <; -{- IkI rIn
OWNER
(Nam,.,
(Address)
APPLICANT
(Name)
(Address)
/
Quantity
;;,t ~~~U""' I PERMIT NO. !Jt/- t;~t(
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76 U)~r1f~ PID;:}.5- 5of-DfL/-{)
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(Phone) q6ri- dal,-31Qt,
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Type of Fixture
Rough-ins
Water Heater
Water Softner
I Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
I 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
De.Y\.\I\.~~ Wed~J (Phone) L, ~;:}~ RO \- 5 d<4D
~14 A@. AuQ. tl.L\ ~~ 56350
(Address) (City) (Zip Code)
(Contact Person) " ll\(.\( l lUed<}! (phone) -1P I d -&" to i? - 4 (""\~
'---'PPLICANTSIGNATURE~, - ~ ~\ ~ DATE 5-13-()Y
APPLICANT PLE~ COMPLETE 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)
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(om.. Use Only)
~ This Application Becomes Your Building Permit When Approved
Building Officill
Date
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.50
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Paid L/o~ ---
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ReceiPl)'hf3 J
By q
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24 hour notice for ail Inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave" S,E., Prior Lake, MN 55372-1714
ADDRESS
/bft!70
DATE TIllE
SCHEDULED ~~-S~
Sk;')j~ks OJ--
;
CONTR.
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
PHONE NO.
PERMIT NO.
t:!J4 - '/7q'
[J FOOTING
[J FOUNDATION
[J FRAMING
[J INSULATION
[J FINAL
[J SITE INSPECTION
D PLUMBING RI
[J MECH RI
D WATER HOOKUP
D SEWER HOOKUP
~UIIBING FINAL
D MECH FINAL
[J EXIGRADlFILLING
[J COMPLAINT
D FIREPLACE RI
D FIREPLACE FINAL
D GASLINE AIR TST
D
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~WORKSATlSFACTORY.PROCEED
/ D CORRECT ACTION AND PROCEED
D CORRECT ~;/ W-L FOR REINSPECTION BEFORE COVERING
Inspector: f/It--J./ OwnerlContr:
;
CALL "7-8850 FOR THE NEXT INSPECTION ~ HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH" SAFETYI
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