HomeMy WebLinkAboutPlg Permit 05-0484
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
1. Blue File PERMIT NO 41
2. Gold City . 0'5. 0 /fA
3. Yellow Applicant """"'V
(Please type or print and si~ at 1. ::L.'.)
ADDRESS r: !. n ) J
I j' 2- J 6 to. I (WCLl)'H (/lls Pd , )J t~/
() Q . .
LEGAL DESCRlr lJ.ON (office use only)
3/t2 !.~0 j /1 NJIj79
ZONING (office
use)
LOT BLOCK
ADDITION
PID Z~. 37ft;. 01,4-.0
OWNER ~L. ~ J
(Name) Alex ~ ILl n1d/')CI.. titAn tJi?r()~
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. (Address)/S-iJJ~ fai.ru){tw \f(~6 Rei IU~t/. frlot Leh I /l/N J-~5 72-
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APPLICANT Ii If' . {; , } p 17
(Name) n X }l-Il~ ~'LI J5 --' (Phone) .ja/JIJf {/ S {.t.fL,(51/Z_.
(Address) liLt/V! f a.5:' (J, f:-.1te_.
(Address)
(Contact Person) A: l-e X
(Phone) {]~2 - Y Y 7 - zoo Y
(City)
(Zip Code)
Quantity
.~ /r-t,..' ;, L?-...e/',~_ DATE
APPLICANT PLEAsEJCOMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (1 or 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
-n ('.I
(Phone) q),r:. - t; '-11- :J C 0.3
5- / "? /0 S/--
I .-J.. :J .
APPLICANT SIGNATURE
Type of Fixture
t/
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
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 $ J.. 0 00 Building Pennit #
PLUMBING PERMIT FEE $ II () . t l)
STATE SURCHARGE $ . .50
TOTAL PERMIT FEE $ ifl), \"0
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Bundin!! Official
Date
Paid 1"0 , c;o
DateS. '2--7.u \"
Receipt No. 1-'152-4-
By /
24 hour notice for aD inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
DATE TillE
CITY OF PRIOR LAKE ~
INSPECTION NOTICE SCHEDULED
ADDRESS !- 5" 21 (.I ~t~. <<~
ij ,
OWNER CONTR.
PHONE NO. PERMIT NO. ~ {.l e y
o FOOTING o PLUMBING RI o EXIGRADIFILLlNG
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL '~SLI~T
o SITE INSPECTION o MECH FINAL 1- (', I}
COMMENTS:
---
/'
/\ WORK SATISFACTORY, PROCEED
o CORRE A lI'lON AND PROCEED
o COR ECT W~ff'f~LL FOR REINSPECTION BEFORE COVERING
Ins or: A II Y Owner/Contr:
CAJ ~50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
~
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl