HomeMy WebLinkAboutPlumbing Permit 04-0552
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
--
i ~':: ~:~ I PERMIT NO. 04-, 0552..1
3. Yellow Applicant
q?lease ~ or fJriDt and sUm. at bottom)
ADDRESS
IlP860
Lui \\ol.U~ci
~
ZONING(officeusc) I
LEGAL DESCRIPTION (ollice use only)
LOT
BLOCK
AUUIllON
PID
. OWNER
(Name)
(Address)
\)~kv ~uJ(o.n
~
(Phone) (,Id- d~D-'8'a1
APPLICANT "...I I 0 L:-
(Name) u0\.1l\6 \t-..}('(l& (Phone) lP d~6DI'()")t'tJ{)
(Address) lo \4 ~ l2.O 1\ 5W Hu:kJ..Lu.tJYrvl 65,~
(Address) (City) (Zip Code)
(Contact PeISon) ~ l KJ<. \ W td'1<' (Phone) lP I d - g 1.0 <6 -I.{ '-I ~
'-~ ~ l ~ \r '"1 ' aU
/"" ..APPLICANT SIGNATURE '-- _ )X-- DATE 0'"
APPLICANT PL~ COMPLETE BELOW
Type of Fixture Quautity I
Bath Tub with or without shower Rough-ins
Dishwasher I Water Heater
I Floor Drain I Water Softner
I Lavatory (Bathroom Sink) I Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall \ Backtlow Assembly
Sinks Backtlow Assembly Test
I Bar Sink I Lawn Sprinkler
I Water Closet (Toilet) I Other
Quantity
Type of Fixture
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
Estimated Cost $
Building Penn it # 0"". cS5:z...
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
CR/~
.SQ
L/f),Qo
(Omce Use Only)
~ This Application Becomes Your Building Permit When Approved
Building OOicial
Date
I Paid 4-iJ, () 0
I Date
C,.IO. (I 4-
Receip~ "J r
By J
14 hour notice for aUlnspeetions (951) 447-9850, fill< (951) 447....145
16100 Eagle Creek Ave., S.E., Prior Lake, MN 553n-1714
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
/,F~
TIllE
ADDRESS
/t3SV W,,~4~~dCj di-
OWNER
CONTR.
PHONE NO,
PERMIT NO.
ol/-~~
o FOOTING
o FOUNDATION
D FRAMING
D INSULATION
D FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
.rr15LuMBING FINAL
o MECH FINAL
o EXJGRADlFIUlNG
o COMPLAINT
D FIREPLACE RI
o FIREPLACE FINAL
D GASLINE AIR TST
(J
COMM~TS:/ f)/ /J /
~C/~I.J frev<~ fror
,4,--- 4/y~q~pb-
V
n
J'-e'/
-""""'/
C/ (<-
~K SATISFACTORY, PROCEED
(J CORRECT ACTION AND PROCEED
(J CORRECT WORK, CALL FOR RElNSPECTlON BEFORE COVERING
Inspector: ~ Owner/Contr:
CALL 447.1850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH Ii SAFETYI
UGNO..