HomeMy WebLinkAboutPlg Permit 05-0182
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
3 . /4-. 0.5
~~~
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
I Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
I Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
I Bar Sink
I Water Closet (Toilet)
(Please type or print and siltIl at bottom)
ADDRESS
(,541 K(1ea:ky.~ 6P~-t $.e.
LEGAL DESCRIPTION (office use only)
14- ~ IS"
LOT BLOCK ADDITION jGN(5/<1FI6V.s ~O1/6
~~e~Rr orrLth . 'R~
I I
(Address) foS'f/ K~~ 6i. S.6.
APPLICANT A I ~ _I I ~, t
(Name) ~ r/~bl'P1
(Address) /q,IJ~ 6tM:be.ld ~_. btJ.
. (Address)
(Contact Person) ~ f ~ PlUtlj
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'.PPLICANT SIGNATURE
Quantity
L Blue File
2. Gold City
3 Yellow Applicant
I PERMIT NO. O~ , 0/ SZ-
ZONING (office use)
ie/5;O
PID 25.//0. 011.0
(Phone) 1!1szJ~~7-S311
(Phone)
~tr
( ~ 12) fl7 ~ LJ/)3~
*:>~ytf8
(Zip Code)
{"Z)'H27- ~33
3/J /t;S-
(Phone)
DATE
Type of Fixture
I
Rough-ins
I Water Heater
Water Softner
Stand Pipe (Washing Machine)
I Sewage Ejector
Backflow Assembly
Backflow Assembly Test
I Lawn Sprinkler
I 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
Estimated Cost $
Building Permit # 05. 0 167_
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
I
This Application Becomes Your Building Permit When Approved
Building Official
Date
3'i .SO
.50
qO. ao
Paid 4 I'-
0.0 U
Date 4-
'? I ')5
...:::> . " L.
Receipt No. 1- BE I-'{-
,
BYF
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
-.fS-f//
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
[J FINAL
o SITE INSPECTION
COMMENTS:I /
~*;/
,
DATE TIME
SCHEDULED ~~
; e,
Ln ec,/l- ~ '/ C;-
, /'
CONTR.
PERMIT NO.
CJS--/?L
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
~LUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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(!/fC
-
~ORK SATISFACTORY. PROCEED
~. CORRECT ACTION AND PR EED
[J CORRECT WO~K. C REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
'"
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSltOTl