HomeMy WebLinkAboutPlg Permit 04-0766
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
1.1,3.0-1--
1-
1. Blue File
2. Gold City
3. Yellow Applicant
PERMIT NO. a". 01" I
(Please tvue or Drint and si~ ~ at bottom)
ADDRESS 5og0 POrd5(~
..
La.()e...
- ZONING (office
use) It!:4
LEGAL DESCRIr 110 'l (office use lJ)nly)
LOT "3BLOCK 3 ADDITION D~~z..o S'iU'
PID Z6. 319. {J ~z.",o
OWNER
(Name) 3"df'a. \+-a 1'\
~^(\ p
(phone) 9S;;;-t.j Lj 7- ~...s'()(:o
(Address)
APPLICANT
(Name) JO('\Q. .~Q.f'
&('\ () e
(Phone)
(Address)
(Addres:;)
(City)
(Zip Code)
(Contact Person)
(phone)
Quantity
'0- 1-.. DAlE
/i~PLICANT PLEASE COMPLETE BELOW
Typ'~ of Fixture Quantity
Bath T LIb with or ~ithout shower
Dishwasher il
Floor Orain :1
Lavatory (Bathrodm Sink)
Laundl y Tray (1 qr 2 compartment sink
Showe' Stall II
Sinks I
Bar ShJc II
Water ':loset (Toi'\et)
?/d~bL/
r
I
I
APPLICANT SIGNA Tl JRE
Type of Fixture
x
RoQgh-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Eiector
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 Pennit # (S " . (J 7' ,
PLUMBINGPERMITFEE $~,SO
STATE SURCHARGE $
TOTAL PERMIT FEE $
.50
LJ(). (}()
(Office Use Only)
This Application Beco mes Your ""uilding Permit When Approved
Building Official
Date
I Paid ~~ CA)
Dat~ Z3.4 r
-
Rec1'to. ~7.5S7
B~,
o
~
241 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
OITY OF PRIOR LAKE
INSPECTION NOTICE
_ ~ TIME
SCHEDULED ~~~
AL J:~ ~
r/
PERMIT NO. Or'- 7~6
~DDRESS
$OFO
C 'WNER
I
iHONE NO. :
,
I
FOOTING:
FOUNDA TI ON
FRAMING I
[I INSULA TI~ IN
[I FINAL 1
[II SITE INSP! :CTION
CONTR.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
~MBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
I
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WORK SAj.ISFACTORY, PROCEED
CORRECTI ACTION AND PROCEED
, I
9 CORRECT: WOR~ ;JJ;W REINSPECTION BEFORE COVERING
I~spector: ,~/"-- Owner/Contr:
I
CALL 4117-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE RtQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
11'/$1I011