HomeMy WebLinkAboutPlg Permit 04-1131
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
_lease type or print and siltIl at bottom)
ADDRESS Lf as 7
II. I. D 4--
~:~ ~::y PERMIT NO. 04-. 11.3 J
3. Yellow Applicant
CheC/tnu-r LiU1~ Nf.
ZONING (office use)
Je../
(Contact Person) \. Jeff
APPLICANTSIGNATIJRE ~ _ DATE
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)
LEGAL DESCRIPTION (office use only)
LOT
ADDITION
BLOCK
OWNER
(Name)
~ ljC0 ) Krt'5tophtr
41)'=]1 r.nestnut L/Lr1~
(Address)
~~:;~fANT fJ err!?l OYYL PLLunbLnt:1
(Address) '1JlO 5 f:1flP P-(lld AYe; -:9).
(Address)
1J or tJ l C5YVL
Quantity
FEE SCHEDULE
Industrial, Commercial & Multi-family 1 % of job cost with a $39.50 minimum
Estimated Cost $ -Y12/J. ~
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office lJse Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
PIDZS.300. 05z. C
(Phone)
{q5~)441-o/~5
Nt
(Phone) {[.R I),) gj, 7- '-{ o~-o
I m nISI ffitJ ffolfot
(CityJ (Zip Code)
(Phone) {f..pl't-)t~1"4D'33
ID/~o/64
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Building Permit # () ~ ..II~ I
~.5~
.50
Lf.O . f1P_
$
$
$
paid~.OO
Date/I. Z. ~ 4-
Receipt N0"483Z 7
By fM-
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
ADDRESS
1j)~7
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
SCHEDULED
r~t
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
~PLUMBING FINAL
o MECH FINAL
tJatJ\ ~p(;~1 __
DATE
I!~
TIME
((-//s!
o EX/GRADtFlllING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASllNE AIR TST
o
Inspecto :
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
lNSlfOTI