HomeMy WebLinkAboutPlg Permit 05-1188
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
/2 .. .5". dS
~. ~~ ~:~ PERMIT NO. O~. / 111./1
3_ Yellow Applicant 1[;7 "lJ
(Please type or print and sign at bottom)
ADDRESS
J4cgg, T:~vnbefqk1&Q Cirw N[
V
ZONING (office use)
tel
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PIDZ5.259. 013.0
I OWNER D /I Q~r/' '1J;.rL .
(Name) 1)f_..U~U_.Ci\ t\..U) ~ if
(Address) '--- <a.m.J- 11' i or I n J~
(Phone) 051-;)bS~ I (dO
,Mu- 5S37tJ-
APPLICANT ~
(Name) I .LA) O( -k>S'
(Address) 2:)p '70 . CYJd Rd.
(Address)
(Contact Person) l( ( (2 0 f 8h
.P<hiiJ
(Phone)
(Phone) Jf5\- '-~ - '34 ()
f:aC(J.n Mo, Sj/9-3
(Cit# (Zip Code)
05/r3hS-- (3l{O
If -;) J, OS'
DATE
PPLICANT SIGNATURE
{)lR:..h
Quantity
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)
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 Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $ ;J 0 0 . ~
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
J1.5D
.50
/..{tJ. Db
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid 1(J. aJ
Date/Z. 5'. Os
Receipt No. 57J e /2-
By dU/
;r
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
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DATE TIME
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7:~'/~/ t.?4/n C r
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/.(J>[//
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
A'PlUMBING FINAL
- 0 MECH FINAL
S-7/'F
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENT}Jt -' J /., '; I L, / /
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~ATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CAL FOR SPECTJON BEFORE COVERING
Inspector:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOrI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!