HomeMy WebLinkAboutPlg Permit 05-1133
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
/1- r. tJS
I. Blue File PERMIT NO
2. Gold City . 05, //33
3 Yellow Applicant .
(Please type or print and siltIl at bottom)
ADDRESS ZONING (office use)
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APPLICANT f\. W (1""\ c;;: I c:."
(Name) \-Jt...YU'\...tJ) e.cqJ (Phone) lu c7 -DO - 1....lcI(d)
(Address) I 0 I b ?lgll ~\fi.- &J d - I-ILl~ M t.,J 05.3.:v
(Address) (City)
(Contact Person) ~ ~ (Phone)
~PPLICANT SIGNATURE ~ . - \ ~}-- DATE
APPLICANT PLEkj COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
I Floor Drain
I Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
~"
I
(Phone)
(Address)
nO
\\1 \' lElJVt
tM-1
Quantity
PIDZ5.3oo. 037.0
q5d-440-dlo~.J
(Zip Code)
SoJ1.V
Type of Fixture
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
Estimated Cost $
\~C?-
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
2fl,ED
.50
~D.OO
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
/{V--
Date Ii . 10 . () [;
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
Reeeipt NO'SV3 1 S-
BY,f .
U
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS J '-I, 1'S
Q~ LV^-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
Qj~ ~ ~
DATE TIME
\~
5" - Il 53
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
)1!. IrN~
~ORK SATISFACTORY, PROCEED
o CORRECT AC~IO AND PROCEED -
o CORRECyV1 , CALL FOR REINSPECTION BEFORE COVERING
Inspector: & -../J Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
.lNSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!