HomeMy WebLinkAboutPlumbing Permit 04-0791
Date Ree'd
CITY OF PRIOR LAKE PLUMBING PERMIT
7. z. ,.()f-'
~. ~:~ ~:~ I PERMIT NO.O 1-. e 7 if J I
3_ Yellow AppliCUlI
,Please ~ or mint and sim at bottom)
I ADDRESS
J 0 Z:Z_ HJ'/W,f:.-
/UO?6/40 .
. ZONING(o_use)
I!?./r.o
LEGAL DESCRIPTION (ollice use only)
LOT / BLOCK / ADDITION IrIdJe17.HVr/lJD dlf1.t:..:r Z"iR
PID ZS". 37/. 00/.0 .
OWNER
(Name)
(Address)
(Phone)
APPLICANT.--.- ^^ .,n,""
(Name) lot::l.J' y\.,,"-.....
(phone) qs)-I./40-'&'6~1
(Address)
(Address)
(City)
(Zip Code)
(Contact Person)
~~yt~
(Phone)
APPLICANT SIGNA TORE
;-
DATE
'7/~1.{ oL/
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Qnantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall Backtlow Assembly
Sinks Backtlow Assembly Test
Bar Sink X Lawn Sprinkler
Water Closet (Toilet) 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
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit # Ii 1-. 0 7'11 J
3' 9, 6"V
.50
4"0, fA)
$
$
$
Estimated Cost $
(omee Use Only)
) This Application Becomes Your Building Permit When Approved
Building Official
Date
I Paid Ifp.t/U
I Date A_
1. Z/I,().,.-
ReceiP~7 a/J
By --t .
I
24 hour nntiee ror aliin... . ..:. ,(952) 447-9850, rn (952) 447-4245
16200 Eagie Creek Ave., S.E., Prior Lake, MN 55372.1714
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS 4 302. L
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
SCHEDULED
J.l.....k- fJe
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
DATE nME
#
/9./
'-/-~
o EXlGRADlFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
~~~~~E"~
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
alp)
Inspector.
Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTlON:U HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
IN$NUTI