HomeMy WebLinkAboutPlg Permit 06-0344
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CITY OF PRIOR LAKE PLUMBING PERMIT >. 3.otp
(Please type or print and sign at bottom)
I Blue File I PERMIT NO I
2. Gold City . 0(,. 074-1f
3 Yellow Applicant ~
ADDRESS 3SS \ h!1S<:'~ ti r- ::> \,Aj
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PIDZS. I/O. 011.0
OWNER
(Name)
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(Phone)
gS2,yljO' 2tXcO
(Address)
APPLICANT
(N ame)
H.P. PIPEWORKS
3670 DODD HUAO
EAGAN, MN 55123
(Address) (651) 365 134U
(Contact Person) (y-:\ 'S Of/) --..
<\PPLICANTSIGNATURE ~ r,\. ~
(Phone)
(Address)
(City)
(Zip Code)
_ (Phone)
~ DATE
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APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture I Quantity Type of Fixture
Bath Tub with or without shower I Rough-ins
Dishwasher I \ Water Heater
I Floor Drain I I Water Softner
I Lavatory (Bathroom Sink) I I Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 compartment sink I Sewage Ejector
I Shower Stall I Backflow Assembly
I Sinks I I Backflow Assembly Test
I Bar Sink I I Lawn Sprinkler
I Water Closet (Toilet) I I 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 $ 2 LX) . 00
Building Permit #
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ ~}lc;O
$
$ 40,00
.50
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid 4-(), 0 0
Date 5, f/ofo
Receipt No. 57 2.81--
24 hour notice for al\ inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
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.-------
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS 355 I
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TIME
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. PERMIT NO~-I---'_/
OWNER
PHONE NO.
.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
'r::t FINAL Ii c _ fV~ 0 PLUMBING FINAL
....6 SITE INSPECTION ~ q MECH FINAL
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COMMENTS:
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o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
010
rORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORREC'7MLL FOR REINSPECTION BEFORE COVERING
Inspector: ~ ~ . / Owner/Contr:
CALL 44it~ FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
~ .
INSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!