HomeMy WebLinkAboutPlg Permit 05-0577
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
~~;~~ANTtJt1-r6~ t>\oM..tb~ (Phone) (h.2)a27-cfPJl
(Address) 2.q~') L,~/"~/d (;lvL.~. ~/6 ~~~
(Address) ~ (Zip Code)
(Contact Person) ~ -p~ (Phone) [/'12)327-'1I)]J
APPLICANT SIGNATURE ~ ~~ DATE 6JJ:5J'..s-
APPLICANT 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)
(Please type or print and si~ at bottom)
ADDRESS
31810 ~LL-\b-U(\\LtClVcle.
\0.W.
LEGAL DESCR1t' lION (office use only)
LOT
BLOCK
ADDITION
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(Address) (~ f)lh 1Su.kn u:t elf. l).~.
Quantity
~ _ 2D . 65
I. Blue File
2 Gold City
3. Vellow Applicant
PERMIT NO't)5. 057 i
, ZONING (office use)
PID
(Phone)
("52) tJ l/ 7 -.s-3~2
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 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 $
(Office Use Only)
.J This Application Becomes Your Building Permit When Approved
Building Official
Date
3J.~
.50
Lit) . ~O
Paid40,OD
Date t,. zo "OS
Receipt No. ?93 88
By /I~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake. MN 55372-1714
DATE nME
SCHEDULED ~
~ &,,-/l V/ C j-
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
31r6
OWNER
CONTR.
PHONE NO.
PERMIT NO.
D FOOTING
o FOUNDATION
o FRAMING
D INSULATION
D FINAL
D SITE INSPECTION
D PLUMBING RI
o MECH RI
o WATER HOOKUP
D SEWER HOOKUP
~LUMBING FINAL
D MECH FINAL
S--s-? /?
D EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
D FIREPLACE FINAL
D GASLINE AIR TST
o
COMMENTS:4 / /' J #" / /"
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~~RK SATIS
~\6'ORRECT ACTION AND PROCEED
D CORRECT WORK.tA-,~~EINSPECTION BEFORE COVERING
Inspector: ~.v Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl