HomeMy WebLinkAboutPlg Permit 04-0764
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERl\'ul
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i ~~ ~:~ I PERMIT NO.O~. O#"7/_A-
3. Vellow Applicant , ,,-r-
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ADDRESS
ZONING (ollice use)
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LEGAL DESCR1r uON (office use only)
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OWNER
(Name) ---D..o-A Ll+"e..-
(Address) I bt3"'1 Pa.rK 4JN~ E
APPLICANT \\ ,,_ \
(Name) ~A.ne. .$de.
(Phone) crs~. aq~. CJ(z)1
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(Address)
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(Address)
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(Phone) -S.s'd- i'q" - 1Jpo
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(City) (Zip Code)
(Phone) q,S"J- R'I'I- ?/;co
DATE 1-;10-0"/
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(Contact Person) \\a..uL-
APPLICANT SIGNA~RE ~ ~...vg)J(
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Quantity
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)
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
. ,..Backflow Assembly Test
V 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 $39,50
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Pennit # ()4f "P 7 {, ~
31. !"o
,50
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$
$
$
Estimated Cost $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
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Date7. V'~...I ,...,
Rece~ NO~76S!5
By 11 ,
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
ADDRESS
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DATE Tille
tf~y
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
OWNER
CONTR.
PHONE NO.
PERMIT NO.
~LUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o EXIGRADIFILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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Kc;RK SATISFACTORY, PROCEED
fl ~~RRECT ACTION AND PROCEED
o CORRECT WORK.i ~.J'~EINSPECTION BEFORE COVERING
Inspector: p-'Z/ ./ '. Owner/Contr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl