HomeMy WebLinkAboutPlg Permit 02-0768
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'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
Sinks
Bar Sink
Water Closet (Toilet)
(Please type or print and sij1;ll at bottom)
ADDRESS
594-9 ~c;JJ A NO;2#)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
(Address)
APPLICANT / 0 ' /h (
(Name) l--1~ [)~ I ~ C..q , -- / }
{1DP - (7-13' 1vc- rJ
- (Address)
(Contact Person) -- L.e.9 ""'\ O.tr C!""--' ~
'Z-f
(Address)
APPLICANT SIGNATURE
Quantity
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
~. ~~~ ~!:y PERMIT NO'OZ_,,-J/- b.
3 Yellow Applicant V'Ui'V
-
S I .
ZONING (office use)
PID
(Phone)
(Phone) 95-;), 971 )'''':1 k,
tI'o / < rro-> I .rs-7 y r
(City)' (Zip Code)
6r ~ d.ol-I Y J-7 Y'
Wf/~~~
(Phone)
DATE
Type of Fixture
/I
/j
..,
Rough-ins
. Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
Residential, New One & Two-Family
Residential, Additions & Aiter tions
Building Permit # 0 Z-~ 07"
$99.50
$39.50
Estimated Cost $
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
f JtA- ~ . U .. d~
Building Official Date
'J 9~)V
.50
q-o -07 J
pai~. (/l)
Date.
t1' f...,~ -rl.___-
Receipt..No. .
q-z.,') 7 S-
By ,:UJ ~
/
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
,
..
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING @
o INSULATION
FINAL
{ SITE INSPECTI N
COMMENTS:
DATE TIME
S1;~DULED$;~:::J
CONTR.
PERMIT NO.
7hr
o PLUMBING RI 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLINE AIR TST
~~
,
IP j Jt.d
,...
~
)1JWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
CALL 447-9: JR TH'E NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI