HomeMy WebLinkAboutPlg Permit 06-0783
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
;:~ ~::y I PERMIT NO.O ~_ ?().2
3 Yellow Applicant G:::-; ~
(Please type or print and sign at bottom)
. ADDRESS
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ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
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APPLICANT <;:;: /} i-;' (:'-' /) () r r
(Name) Mttt;E1(./J /,.I---r
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(Address)
OWNER
(Name)
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(Phone) 9SJ"'I.(~O --~ J b 7
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(Address)
(Phone)
(Address)
(City)
(Zip Code)
(Contact Person)
(Phone)
APPLICANT SIGNATURE
Bvl'o-f
5 ~ \u.r
DATE
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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 $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOT AL PERMIT FEE $
(5 9- 50
.50
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(Office Use Only)
I This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid L( tJ------
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Receipt NO'1
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By
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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
DATE TIME
SCHEDULED ~~~
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CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
3:.-? U
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
~MBING FINAL
'0 MECH FINAL
~ - 7J:.5
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
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~ SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORW>~REINSPECTION BEFORE COVERING
Inspector: /~U / ../ Owner/Contr:
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CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!