HomeMy WebLinkAboutPlumbing Permit 04-0936
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
APPLICANT f\. ' I. u L
(Name' utV\l'\ I S l,JJC.CA.cy (phone) (p I d' 8b 1- ~
(,14 D'~g Aue"s..u HuJc~ 66360
(Address) (City) (Zip Code)
(Contact Person) N\KJ(\ ~ (Phone) ~ld'?{,fS-lf<t6{o
APPLICANTSIGNATURE~ . t ~ ~ DATE
r- APPLICANT PL~SE COMPLETE BELOW
Quantity 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)
.ease ~ or print and sijt[l at bottom)
ADDRESS
1535&
tD..~ ~
LEGAL DESCRIPTION (office use only)
LOT
ADDITION
BLOCK
. OWNER
(Name)
(Address)
In \v\. :, L' IW\.
Ca,yl5lY\
tic:u1U
(Address)
9.1~ .0-1-
; ~~ ~:~ I PERMIT NO.O". 0 93'-1
). Yellow Applicant ~
ZONING (office use)
PID ZJ',..3'S2-, 08~. 0
(Phone)
f1/o'la/rD16f/
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow 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 S99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
)ThiS Application Becomes Your Building Permit When Approved
Building Official
Dat~
(H-, ()~"
~'f ' ti)
.50
40.m
Paid .AJI
-rv. (/l)
Date A " A--
..,,/11 .Dor
ReceiP~No. +181Z-
~
U
24 hour notice for aU inspections (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 153'58
OWNER
PHONE NO.
[J FOOTING
[J FOUNDATION
[J FRAMING
[J INSULATION
[J FINAL
[J SITE INSPECTION
COMMENTS:
DATE TIllE
SCHEDULED I~
~~t~
CONTR.
PERMIT NO.
<(- ,~
[J PLUMBING RI
[J MECH Rl
[J WATER HOOKUP
[J SEWER HOOKUP
[J PLUMBING FINAL
[J MECH FINAL
[J EXlGRADlFILUNG
[J COMPLAINT
[J FIREPLACE Rl
[J FIREPLACE FINAL
[J GASUNE AIR TST
~ I........ Sptl""<...-
../
S0
u
UV
/WORK SATISFACTORY, PROCEED
[J CORREpjlON AND PROCEED
[J CORRE RK. CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CAL{L7.9850 FOR THE NEXT INSPECTION 2. HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH" SAFETY/
-,