HomeMy WebLinkAboutPlg Permit 05-0352
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
1. Blue File I PERMIT NO
2. Gold City 'Oc-'. 0 -?~2-
3. Yellow Applicant .....,. ~ v
(Please type or print and sign at bottom)
ADDRESS I J '2 J L 0
..,., ohore UU1&
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ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
~~e~R f{jorLin. E:lLLaban
(Address) 142J-IO ISYtoye, ULn& N&.
~;;~~ANT N oYb l ()YYl t>LlUYl.-bf n tf
(Address) Lqos tuLr.fitld ftYe'/ SoJ
(Phone/QSL) Ifl-/ 'j-Ql/7
(Phone) (lJ;I~) g~7'4 O~?;
, (Yto l s. S'J-Io~
(Address) (tity) (Zip Code)
(Contact Person) ./tYn u 1) r .p aU,l (Phone) (LP/1-) ~~ 1 ~ 40 '13
A.PPLICANT SIGNATUPJi ~{I /' DATE t/ /2?J I n<;
. A;;~ICANT PLEASE 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)
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backtlow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
Industrial, Commercial & Multi-family I % 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 $
0i.5.!
.50
LfO .O'p-
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid f (J.e,V
Date 4' '2--9. {/S..-
Receipt No. . -'l....
~flJ f(~
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
SCHEDULED
DATE TIME
6M-s-
,
ADDRESS
/'/,2 yo d,e L~~-<-
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
~UMBING FINAL
o MECH FINAL
os- SS-,:z
o EXIGRADlF/lllNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASlINE AIR TST
o
COMME~: ~ I
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;r'ORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, C~ }~IN~PECTION BEFORE COVERING
Inspector: F~ vwner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!