HomeMy WebLinkAboutPlg Permit 04-0834
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
B. I /, ~4-
I. Blue File PERMIT NO 4
2. Gold City '04-. 0 fJ.? -
3 Yellow Applicant CI~
,Please type or print and sign at bottom}
. ADDRESS '60d4 &':x..o-t W~
ZONING (office use)
~I
LEGAL DESCRit' lION (office use only)
LOT3 , BLOCK' ADDITION W( 00 J J r/U'T/rY
(Address)
fY\o..N'i CaS0et5
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5aJt1tV
PID zs: :3Cz. ~ 03 L D)
(Phone) 't6d -4ljj-g>g 8'3
I OWNER
(Name)
APPLICANT f'\. . \/\.1~
(Name) kJO\.!tUJ)? b - .{
(Address) LP 14 {~ (ll .rt 6W
(Address)
(Contact Person) ~ [( <l W~
( ."") '_ t \ .
APPLICANTSIGNATURE~_- \_ IV-- DATE
APPLICANT PL~E COMPLETE BELOW
Type of Fixture Quantity I
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 Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink ../ Lawn Sprinkler
Water Closet (Toilet) Other
(Phone) lo I d -&J I - (b> &0
Hu:lrhU1~ ~5:~6{)
(City) (Zip Code)
lot 0 ~ ~& -4l{:5fa
(Phone)
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
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit # ()4-. off#-.
..50
, .50
.ef-O. 00
$
$
$
Estimated Cost $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Pai~ 0 0
q.O.
Date
8.J~.04-'
Receipt ~o'47599
BY~ ·
24 hour notice for all 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
30d-..L{
DATE TIME
SCHEDULED I~~
. 18,0 ~ cA;j/
ADDRESS
~
OWNER
PHONE NO.
CONTR.
PERMIT NO. ~ ' L/-aYI
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
o EX/GRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o Gl~L~E~~
)t. _ .
COMMENTS:
./
I 'J~
/) 0
( /-
~
-
~ORK SATISFACTORY, PROCEED
o CORRE~T C N AND PROCEED
o CORRE f"OR. CALL FOR REINSPECTION BEFORE COVERING
Inspector i Owner/Contr:
CALL /l7'~ FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
COD':i4UlREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSI'IOTI