HomeMy WebLinkAboutPlg Permit 04-1096
CIty OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
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ME
I. Blue File I PERMIT NO I
2 Gold City . /fA., /0 r/ ,~
3. Yellow Applicant ~ / re;7
ZONING (office use)
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(City) (Zip Code)
(Phone) qSJ. - .I.I'I&' -S8~~
DATE I (J -/q-d 'f
OWNER
(Name)
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NE
(Address)
APPLICANT J ..
(Name) ~_~ ~
(Address) 5::l 3
! (Address)
(Contact Person) ~>-h ~rd~
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APPLICANT SIGNA TUlrn
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(Phone)
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APPLICANT PLEASE COMPLETE BELOW
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Quantity
Type I~f Fixture
Bath Tu~ with or ithout shower
Dishwasller I
Floor Dr.lin
Lavatory (Bathroot~ Sink)
Laundry [fray (1 orl2 compartment sink
Shower Stall I
Sinks
Bar Sink I
I
Water Closet (Toil t)
Quantity
Industrial, Commercial ~famil\;
FEE SCHEDULE
o of job cost with a $39.50 minimum
ost $ _1SlJ. (JO
Type of Fixture
I
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Building Permit # tJ4. / () 9 (,
(Office Use Only)
~. This Application Becomes Your Building Permit When Approved
, I:
Building Official !i
I,
24 b'our notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
Date
:~q~oo
,50
,~ .$0
Paid IfO i U)
Date
/0 ,z,z.,.() tI-
Receipt No. ~
7 D'3i!J (P
By fD4-
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ADDRESS
OWN~R
;~Y tf'S-
I
DATE TIlle
SCHEDULED /(/7/0/
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CITY OF PRIOR LAKE
INSPECTION N0111CE
CONTR.
PHONE NO.
PERMIT NO.
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i'
o FqoTING I,
o FQUNDATION i
o FRAMING
o INSULATIONl
o FI~L
o StilE INSPEC ON
COfJIMENTS,
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~
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
~UMBING FINAL
o MECH FINAL
o EXIGRADlFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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{_~{/~75/).J-/#Y cY/c
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~RKSA~rSFACTORy.PROCEED
~~ORRECT ~CTION AND PROCEED
0' CORRECT.~.I'~' A L F REINSPECTlON BEFORE COVERING
Ilh
Inspector: (./ ~ /" Owner/Contr:
CALL ""7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE i,QUlREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
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