HomeMy WebLinkAboutPlumbing Permit 04-0537
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
670f-
. ,
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APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
I Floor Drain
I Lavatory (Bathroom Sink)
I Laundry Tray (I or 2 compartment sink
I Shower Stall
I Sinks
I Bar Sink
I Water Closet (Toilet)
Q?lease ~ or mint and sim at bottom)
ADDRESS
..57J 0 e
;::'0 /1/ f)..J e:Z::)(y'b
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
AUUl110N
OWNER
(Name)
(Address)
APPUCANT <') ) -1
(NameL~ t<.. 0J..~ r C.' I~
(Address) t.{*ffJ ~~h I4AuZ'.,u
(Address)
(Contact Person) .AJ..,.... /...J ,f,p/L.
. I
,..--. \PPUCANT SIGNATURE (j 0 _ 1_
~
:y.~,
~
Quantity
FEE SCHEDULE
Industrial. Commercial & Multi-family I % of job cost with a $39.50 minimum
Estimated Cost $
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Om.e Use Only)
r- This Application Becomes Your Building Permit When Approved
I
Building Omclal
Date
L Blue File I PERMIT NO I
; ~::". ~~n~. .tJ~. oS?J
I ZONING(OfficelLSe)
~~
PID 2.S: 399 OLf ()
(Phone)
(Phone) t. ( "L q?, f. ~ q 'to
6.'A rfJ.,.,..1..6L. 55330
\) (City) / (Zip Code)
(phone) 6(2. '{fif. 31"0
DATE ~....,
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backtlow Assembly
~ ~acldlow Assembly Test
/ \ Lawn Sprinkler
Other
Residential. New One & Two-Family
Residential, Additions & Alterations
Building Permit # II-. (IS 37
a 9. 5tJ
$99.50
$39.50
$
$
$
.50
<nJ _ c/7J -
r Paid tf-o ,C/O
I Dat~_ J"r f-
Recei~No~ t?7..I
By;/:-.
U
24 hour nolice for alllnspeclions (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
S'OCl~
OWNER
PHONE NO.
[J FOOTING
[J FOUNDATION
o FRAMING
o INSULATION
[J FINAL
o SITE INSPECTION
DATE TlIIE
SCHEDULED /..$6~
A;z~ec&p, ~r-
V
CONTR.
PERMIT NO.
~UMBING RI
[J MECH RI
[J WATER HOOKUP
o SEWER HOOKUP
~MBING FINAL
o MECH FINAL
~ij -..s:? 7'
[J EXlGRADlFILUNG
[J COMPLAINT
[J FIREPLACE RI
[J FIREPLACE FINAL
[J GASUNE AIR TST
[J
COMMENTS: .,/ 4 ~
~~'f-" -::>;tJ,-,;" ft/eY:
P-..c /c -f-MLA/" P?~U1!'~ 1(..-
/;7// /;)- 7-;;6(" f'J
~("P /?'.20
m#?~"rs ~ be
/')Zv-P ./?/Q It -.oS /-
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arr,
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~RK SATISFACTORY, PROCEED
~RRECT ACTION AND PROCEED
o CORRECTWO~~~~INSPECTION BEFORE COVERING
Inspector. .H"~ Owner/Contr:
CALL ..-7.9850 FOR THE NEXT INSPECTION 2A HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PElI.SONAL HEALTH I< SAFETY/
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