HomeMy WebLinkAboutPlumbing Permit 04-0655
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
(, . z.q. 04-
APPLICANT" r I \... .J n <;A/\
(Name) u~ v....JVJ.~ JL (Phone), 10 I a - OLJ'- ~dlL>()
(Address) tol LI o3@ A\.:R. ~ l-\~ 5"'l~"'(>
(Andress) (City) (Zip Code)
.
(Contact Person) N~ Wed~ (Phone) to l d -8l,p '8 -445(0
r- ~ I ,\ I -'1j.OCl.
.PPLICANT SIGNATURE ~ \ '_ \ A p... DATE lP 0> 1
APPLICANT PL~ 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)
(Please tvp<;. or mint and sUm at bollDml
I ADDRESS 5cP lu p~(&Qt loJ,u
-
LEGAL DESCRIPTION (office use only)
. LOT C/. BLOCK l ADDITION t7~4QIt) C(1lt
OWNER
(Name)
~ S~V-
~
(Address)
Quantity
I
l:% ~~ I PERMIT NO. 0 +-. Or, 5S I
3. Yellow Applicant
ZONING (0__)
PID U.1Qtt.OI'f. V
(Phone8::sa -ddlo - d04(o
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backtlow Assembly
Backtlow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
Industrial. Commercial & Multi-family 1% of job cost with a $39.50 minimum Residential. New One & Two-Family $99.50
Residenlial, Additinns & Alterations $39.50
Estimated Cost $
I~O~
Building Permit # t)~ 66,.ra
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
.~ This Application Becomes Your Building Permit When Approved
()q . 5()
.50
'10.~
I Paid-fO,&0
I Dat&. ?--1 ,() 4-
r
Building Officlal
Date
Receipt N-o/].,;t.3 4--
By d-
U
24 bour notice for all inspection. (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
~t:
OWNER
PHONE NO.
[J FOOTING
[J FOUNDATION
[J FRAMING
[J INSULATION
[J FINAL
[J SITE INSPECTION
DATE TIllE
SCHEDULED I'~~~
/t~cie~~ L
CONTR.
PERMIT NO.
($f/-~.n -
[J PLUMBING RI
[J MECH RJ
[J WATER HOOKUP
[J SEWER HOOKUP
.A!J'15[UMBING FINAL
[J MECH FINAL
[J EXIGRADlFILLING
[J COMPLAINT
[J FIREPLACE RJ
[J FIREPLACE FINAL
[J GASUNE AIR TST
[J
COMMENTS:.., __ / /
/1'~~ /'L~rJ;'" ~/t!""'-- /
.//4C--~ H~ h~...,"t!-- 7-t'.Y"
- /
C./t'C
40RK SATISFACTORY, PROCEED
/6- ~~RRECT ACTION AND PROCEED
[J CORRECT WORK, ;/ay:/'Y REINSPECTION BEFORE COVERING
Inspector. ./~ OwnerlContr.
CALL "7.9850 FOR THE NEXT INSPECTION 2. HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH 01 SAFETY!
-,