HomeMy WebLinkAboutPlg Permit 06-0676
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
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; ~~~ ~:~y I PERMIT NO. 0/ . 0 /7~ I
3 Yellow Applicant (f) (J?
(Please type or print and sign at bottom)
ADDRESS
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ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
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OWNER
(Name)
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(Phone) ,'S). - 4(.(0 -91??
(Address)
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APPLICANT
(Name)
(Contact Person)
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(Address)
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APPLICANT SIGNATURE L~ V.~ DATE Jl.E'
APPLIC{NT PLEASE ~MPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
I Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
I Bar Sink
I Water Closet (Toilet)
(Phone)
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(Address)
<.A-v~..e.. )"YI,J. ~ _~ "3 7 Y
(City) J (Zip Code)
(Phone) tlJ- ~c.,-t{ 73/
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Quantity
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 $
.::J 'f, 5'0
.50
+0. () t)
(Office (Jse Only)
This Application Becomes Your Building Permit When Approved
Paid
Receipt NOS/If'! 0
I
By j.
()
Building Official
Date
.f0 . 0 0
Date
1 . t-PJ .0 ft;
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
8./. &7(,
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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
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
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o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
)-
/
./
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~SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL E REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!