HomeMy WebLinkAboutPlg Permit 06-0021
~
/
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
(Please type or print and siJltll at L ~ ..~_)
L Blue File PERMIT NO. O~~ . 00 '? I
2. Gold City \e' c.-
3. YeUow Applicant
ADDRESS
is t \ 0 n~h ?Olll\ t- 120z~ . S~
LEGAL DESCR.1r lION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
W ll+..p. ,C; trO~
\h c,*o(" \ ~
(Phone)
(Address)
<;?..lM -e....
({p(2-
"
~;~~~ANT "-, orbloW"\ PluWl bl~~ (Phone)
(Address) ~90S- ~~r-Ael J, 7k~_ 5 Md~
(Address) . (dtyf
(Contact Person) (\../.-J.JJ rU (Phone)
"PLICANTSIGNATURE 'fiWIU.J~ DATE
l:{PPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
Quantity
ZONING (office use)
PID Z(". 03Q .00 r. 0
yy') - 2')2--L
~2-? - 4033
Sse..{ r) 8
(Zip Code)
12--2~-OS-
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
I
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 Pennit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
~~50
. .50
'-(0 ~
(Office Use Only)
~his Application Becomes Your Building Permit When Approved
Paid 10-
Date/.- 1. a (y
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
Rece~t No. 5lJ !JS3
BY1.
o
ADDRESS
/S-/ /0
DATE TIME
SCHEDULED ;,I~~~
? '
~/ ~~/21
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
~ --2/
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" ...:JMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMME~: / f
Ze{#/ac/ed
, I
~ _ / J/ I'
U/~ 7? r ~t? 77:r-
/7 J 1'.
( .~,HfA ~ Q -f--1. 0 k
,.,4'
~L/
..-"1/
G// c..
~ _/. /
~r/.
/
/
O/C
#RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~~W'REINSPECTION BEFORE COVERING
Inspector: f/ ~~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
lNSNon