HomeMy WebLinkAboutPlg Permit 02-0731
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
ra-18-0?-
I. Blue File PERMIT NO
2. Gold City . 0" - 0-1;> I.
3. Yellow Applicant c..- . I..::J
(Please type or print and sign at bottom)
ADDRESS
~ 7 ~x /YI/ L- 7Z..t-
ZONING (office use)
,(:; Z-
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID Z5 - 385" - {)(J.3- ()
OWNER
(Name)
(Phone)
(Address)
~;;~~ANT t1 tJore ,....fJ100/'<! WaHr T~fw1~~tone) 1-76 J- ~ ~q-708"7
10336 =<.CfqL:.b a~;1. fJl'/hcc ~VJ 11111. ')S 5 7/
./J (Address) (City) (Zip Code)
V t?1 VL (f/ () () rt!- (Phone) 76 '1- ::2 8"6 - 0 I ~ )
APPLICANT SIGNATURE Oa..l'~ ~~ DATE b -IR-O<
(Address)
(Contact Person)
Quantity
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity I Type of Fixture
Bath Tub with or without shower I Rough-ins
Dishwasher Water Heater
Floor Drain )(' Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (1 or 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 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 # () '2.., Cf7.:? /
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
39.50
.50
'HJ.OO
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
. Paid ~_
~O. O'V
Date
6 -Ig. o~
Receipt N~Z3'&6
By it'
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
DATE TIME
CITY OF PRIOR l.,AKE t.-JO-A 1t.1
INSPECTIoN NOTICE SCHEDULED ,-
35'~ 7 ......-.-- ....
ADDRESS 9-oy7adTv
OWNER CONTR.
PHONE NO. PERMIT NO. ~ - /3l
o FOOTING o PLUMBING RI o EXIGRAD/FILLlNG
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULA nON o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL o GASLlNE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS: fl::.. /) ~/
V'.-.
'I'
flY
..' ./
J::.SATlSFACTl>RV, PROCEED
4::E~T ACTION ~ND PROCEED
o CORRECT ~ ( :ALL FOR REINSPECTION BEFORE COVERING
Inspector: \ \ \ ()..A,tt Owner/Contr:
CALL 44;.9850 FOR THE ~XT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
/liSNOTl