HomeMy WebLinkAboutPlg Permit 06-0375
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Ree' d
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
(Please type or print and sign at bottom)
ADDRESS
55 ~ 3 ~~r\A.WV\ Sh()rc,~T ~;\ SE
LEGAL DESCRIPTION (office use only) 0
LO.0~LOCK / ADDITION /.ct1:;ir~
OWNER
(Name)
tJ 0.1/\ '-'IV e. \ }-o f')
SS 11 ~;'f'\o.w~
SE:
~ hute lrr.t; 1
(Address)
~~~~~ANT) t-e I'n KrrA.l4.S P l ~....~jf1 '1
v
(Address) 1\ 2-~. ~+~ ~+. S+e. lO\
(Address)
(Contact Person) ~ m
! APPLICANT SIGNATURE ;:Jz/ftv ~
Quantity
~. .
~mKS
Bar Sink
Water Closet (Toilet)
i ~I~ ~!~y I PERMIT NO/. '1//1_ -:Jfl_C-
3. Yellow Applicant /1 // :::::J' / _---.;
ZONING (office use)
/61
PI~S-= ;j, ~ q . {) J;) -()
(Phone)
(Phone) q J 1. '3 ~ I -0, 't y.
ChCl.Sk.... SS'l/f
(City) (Zip Code)
(Phone) q r 1. -JL I-C/2Y"
DATE 5'-/0 -ob
Type of Fixture
1
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 $
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Building Permit #
Jc.t.s-o
ti .50
Lf1> .00
Paid qO.-
~: (Q.-O~
ReC~NIL/fJ-b
By
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake. MN 55372-1714
d-
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
~~
"
ADDRESS ~S-S.s k~?v'~ Sk~eJ
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
~UMBING FINAL
o MECH FINAL
.h -_ ??5~
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COM*1ENT_~ /' /. / /
/Le;jt/'Hc.ed ~t;.1e'- '?~~.7C~
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Le3~ h G/O hOp'
AJ--
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,
02
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C//€
~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W/~'=27INSP':ON BEFORE COVERING
Inspector: f' t;../ Z- uwner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!