HomeMy WebLinkAboutPlg Permit 03-0723
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
II
I. Blue File
2, Gold City
3, Yellow Applicant
PERMIT NO. 03- '7~
(Please type or print and si~ at ~ottom)
ADDRESS
2+25 I..:J'/ c)N&veesT fJ/177i
LEGAL DESCRIy nON (ollltt ... 4y)
LOTb BLOCK I ADDITIO~~ O~
ZONING (office use)
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PID ~5'(~~q-()Oh"()
OWNER
(Name)
,-~k A. ~~
,
(Phone) Q5'2- S/t:J8-/7'1B
(Address)
APPLICANT
(Name)
(phone)
(Address)
(Address)
(City)
(Zip Code)
(Contact Person)
(Phone)
~PLICANT SIGNATURE
j~4 ':t~-~~
- -
DATE
w~
/ ,
Quantity
I
1PPLICANT PLEASE COMPLETE BELOW
Typel!of Fixture Quantity
Bath Tub with or ~'ithout shower Rough-ins
Dishwasher Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks i Backflow Assembly Test
Bar Sink Y- Lawn Sprinkler
Water Closet (Toikt) Other
Type of Fixture
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 $
TOTALPERNDTFEE $
39_50
.50
+0.00
(Office Use Only)
;-l This Application Becomes Your B, i1ding Permit When Approved
I
I:.
Building Omcial
Date
-
. pai~t(~) ~
Dat~ -5-3
~
. Rec~4~ 75
B~
. ( 0 "rV
24 hDur 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 NonCE
ADDRESS dl. t./.2s--
'i
OWNER
PHONE NO.
[] FOOTING
[] FOUNDA TI~N
o FRAMING I,
[] INSULA TIO~
o FINAL
[] SITE INSPE ::TION
COMMEN~:
DATE TIME
SCHEDULED 7-/~
~-(\~
CONTR.
PERMIT NO.
~-72.."!
[] PLUMBING RI
o MECH RI
[] WATER HOOKUP
[] SEWER HOOKUP
[] PLUMBING FINAL
[] MECH FINAL
o EXIGRADIFILLING
[] COMPLAINT
o FIREPLACE R1
[] FIREPLACE FINAL
If qASLINE AI~.~~'b-:-
;It{ ~ J:~__
/'
./
~WORKSATI FACTORY,PROCEED
[] CORREC TION AND PROCEED
o COR CT CALL FOR REINSPECTION BEFORE COVERING
Ins
Owner/Contr:
7!~9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
-,
-.~