HomeMy WebLinkAboutPlg Permit 05-0185
CITY OF PRIOR LAKE PLUMBING PERMIl
Date Rec'd
3. /&.06
(Please type or print and siAA at lM'u~)
ADDRESS
~()9{) 1/J//leicJ/J d~~O ~
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
(Address)
LA/;Jy'NC
,
0(/-1'0 ;J
,
APPLICA~ r- I '
(Name) Lb-r()v'r~''''' ~ ~ '.LJ //'VI b 11/1.7
(Address) 7(YJCf l J ,'/#J 1""11 c... AVIL
(AddressY
(Contact Person) -A~OY'\t I-~~~j
"PLICANT SIGNATU~ ... \
----...->
I. Blue File PERMIT NO
2. Gold City .~S. of. {} S
3 Yellow Applicant O.
ZONING (office use)
PID 2.~. /~,0. 005.0
(Phone)
(Phone) 9<!\z ? C) 7 '3.~ s(')
S . ~+. lnu-..'~ 1=>6V~ MN.
(City) ~5 +2~ (Zip Code)
(Phone) 162 2~?. ~SSC
DATE :1 -Ib- ()~
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)
Quantity
Type of Fixture
I
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
. Sewage Ejector
I 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 $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
"'his Application Becomes Your Building Permit When Approved
Building Official
Date
:? 752)
.50
41J. (/V
Paid 4-0 J dlJ
Dat:.:?I"" c.5
Receipt No. ~p .tfh
By ff/
I
24 bour 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
SCHEDULED
DATE TIME
3Jft7 CIS-
ADDRESS
1-C90 f/l/ItG Or-! tf-<ADGc-
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
~LUMBING FINAL
o MECH FINAL
COMMENTS: /7 :/
/G?#4-c~.d
,/
/") / /
~P7/okf no"'-.
Ore
/
,/ /
~/ /-/
I
5 "'/&S-
o EX/GRADIFILlING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
~ASL.INE AIR TST
r-1:lz 0 1IiK- .
r /' _ / / // /'
~ rc.,,-.~.*r
tdJ
/'r./ r-
$/(
;( WORK SATISFACTORY, PROCEED
/b CORRECT ACTION AND PROCEED
o CORRECT WOR~~)- rEINSPECTION BEFORE COVERING
Inspector: / ~~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
IliSNOrl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!