HomeMy WebLinkAboutPlg Permit 06-0040
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
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ADDRESS ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT BLOCK
ADDITION
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OWNER ~\
(Name) ~..t\..LL v~u.\J~ i'{"'\..
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(Address) 'fT)t:; \2t)V'\dl\.f~. A-Y-- ~\Occv\ CSS\al-
(Address) (City) (Zip Code)
(Contact Person) \'-,,~n'\L- \"tQvvUcw'-d (Phone) tob\--Lt..fo- 901t
-4PPLICANT SIGNATURE tf~\~.R--~ l"_ ~ II uQrl'rt2l DATE \ l to\D\P
(Phone)
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(Address)
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APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity TYl>e of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher l Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (1 or 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) I Other
FEE SCHEDULE
Industrial, Commercial & Multi-family I % 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 $
TOTAL PERMIT FEE $
~C1, SO
.50
40.00
(Office Use Only)
."-L This Application Becomes Your Building Permit When Approved
Duildin!! Official
Date
Paid ~ __
Date/. /3. 0&
Receipt No. SJ8t:;i-
/1
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
OWNER
DATE
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CONTR.
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
PHONE NO.
PERMIT NO.
~-10
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
....,a--PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENiS:., / _ / / /
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~ SATISFACTORY. PROCEED
o CORRECT ACTION AND PR EED
o CORRECT WORK, C L INSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSNOTl