HomeMy WebLinkAboutPlg Permit 05-1082
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Date Rec'd
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CITY OF PRIOR LAKE PLUMBING PERMIT
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L Blue File
2, Gold City
3, Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS
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LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION
OWNER
(Name) 1) eJ? Li +-i-u-e/"'
q <sJ. 707. Ptf?O (Phone)
(Address) S~
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APPLICANT
(Name) fYl (Gi..lj{P m-nr.t ,-Ym~ (Phone) qJd)
(Address) (d):) j:J-fIl Ave S I-!Of)/1.1 (I)
(Address) , (City)
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APPLICANT SIGNATURE j"V1 JdLo frt c ~~ DATE
APPLICANT PLEASE COMPLETE 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)
Quantity
10. ~tJS
PERMIT NO. 05'. I CJB 2-
ZONING (office
use)
PIDo. 310.010.0
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(Zip Code)
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Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Eiector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
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FEE SCHEDULE
Industrial, Commercial & Multi-family 1 % of job cost with a $39.50 minimum
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Re~~~~~,~~diti~~~~_~terati~ns ~~
Estimated Cost $ 35 OlJ~ OC> Building Permit #
PLUMBING PERMIT FEE $ :~C)..c)D
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $ 40 " tn)
(Office Use Only)
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< "I"'his Application Becomes Your Building Permit When Approved
Paid 10-
Date/D. .1-7. tJ S-
Buildinl! 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
Receipt ~o. ..5t.Y~
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DATE TIME
SCHEDULED ~~~~;--
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CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
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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
,....B1'[UMBING FINAL
o MECH FINAL
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o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
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COJIJIIENT&t /. / , / /
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'~ORK SATISF~t<V~t:t:u
~RRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~r/Contr:
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CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
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