HomeMy WebLinkAboutPlg Permit 02-0864
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
1. Blue File I PERMIT NO g
2. Gold City . A'1 _ 0- J ..:..
3. Yellow Applicant , ~ D-l..I.I ~
ADDRESS
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ZONING (office use)
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LEGAL DESCRIPTION (office use only)
OWNER
(Name)
ADDITION
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(Phone) 70"7- - ryp- 36e7,-~
(Address) :3 0 ~6
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(Address)
(Phone)
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(Zip Code)
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(Contact Person)
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(City)
APPLICANT SIGNATURE
DATE
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain I Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
FEE SCHEDULE
Industrial, Commercial & Multi-family I % 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 $
TOTAL PERMIT FEE $
<59, ~()
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40,0
(Office Use Only)
Building Official
Date
This Application Becomes Your Building Permit When Approved Paid
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
INSP~CTIO_N NOTICE
OA TE TIME
SCHEDULED
1t>-15-0L 4:00
ADDRESS. ]08~ lo-k ~ c:+-
OWNER
CONTR.
~
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
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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 CORRECT ACTION AND PROCEED
o CORRE K, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CA
850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSJiOTI
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