HomeMy WebLinkAboutPlumbing Permit 04-0865
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
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(Address) 1lt-lctaV fJad.L1u ard~
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~~;~~ANT Nor V L 0YY1. PUunb c.h q
(Address) 1J1o 5 81JU off.tLd /tV. Stf
(Address)
(Contact Person) AYYl L1
APPLICANT SIGNATURE t){jll~
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APPLICANT PLEASE 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 ~ or mint and sim at bottom)
I ADDRESS 14/QO
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LEGAL DESCRIPTION (office use only)
LOT:J... BLOCK L/ ADDITION
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OWNER
(Name)
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Quantity
I. Blue File
2. Gold City
3. Yellow Applicant
I PERMITNOtJt;_g~1
. ZONlNG (o_use) I
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PID :;5-t/~-CII~.'-O
(phone/ q 'Ei2.. ) LfL{ S - D 17 5
(phone) (/0/'2..) ~~7' L{D?3
m..01S, '55l-/D8'
(City) (Zip Code)
(Phone)
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DATE
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Type of Fixture
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Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
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FEE SCHEDULE
Industrial. Commercial & Multi-family 1 % of job cost with a $39.50 minimum
Estimated Cost $ 400.02
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
J This Application Becomes Your Building Permit When Approved
Building Official
Date
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Building Pennit #
2A,5Q
.50
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I Paid L/O:--
I Date t;('r ?'I--II
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24 hour notiee for all inspeelions (952) 447-9850, fax (952) 447-4245
16200 Eagle ereekAve., S.E., Prior Lake, MN 55372-1714
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS L419() ~Gt'~ ~ .
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
DATE
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o EXlGRADlFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
j~~A~~c.o .
fWORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORr-flr;:;. CALL FOR REINSPECTION BEFORE COVERING
,nspeoto\!J7_ Owner/Contr.
CALL ~7.9850 FOR THE NEXT INSPECTION:U HOURS IN ADVANCE.
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CODE REQUIREMENTS AIlE FOR YOUR PERSONAL HEALTH & SAFETYI