HomeMy WebLinkAboutPlg Permit 02-0718
CITY; OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
(p -/tf. () z-
I. Blue File
2. Gold City
3. Yellow Applicant
PERMIT NO. ()z... 0 7/~
(Please type or print and sign at bottom)
ADDRESS
4-- /34- e..o t-O ~ 0 Sf.
ZONING (office use)
,e/sO
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID zS- ooG -031>- ? _
OWNER
(Name)
(Phone)
(Address)
APPLICANT I)~ Ie.. ~
__,J..,
(Phone)
(Address)
(Address) (City) (Zip Code)
Ir:.1IIIll!!~fJ. ~~.lP. ~O ....".~I~ aOI-QbOO
-:5~i'lUaJ!hr~-f: ~(' lAA. () ~11./mr'~ ,,'4-2..00"
APPLICANT PLEASE COMPLETE BELOW
Quantity 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 I Lawn Sprinkler
Water Closet (Toilet) Other
FEE SCHEDULE
Industrial, Commercia! & 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 # 0 2. - 071 tJ
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
..:3~~U
.50
~.(JQ
(Office Use Only)
This Application Becomes Your Building Permit When Approved
f!11A-- ~ -,~ .oz--
Ifuilding Official Date
Paid 4O.a 0
Date
{, -( "" - 0 -Z-
Receipt N04- Z-I 'i' Z-
By J'L-
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 LAKE q~'W
INSPECTION NOTICE SCHEDULED
~
ADDRESS 4)34 Co 'Of'~1o
OWNER CONTR.
PHONE NO. PERMIT NO. D"R-7/A
o FOOTING o PLUMBING RI o EX/GRAD/FILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL o GASLlNE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS: }OuJtA ~r\ ",l e.r a?'\"\
VIA ou) t'L8v' )
'- ~
C-,O"e .\: ;\1'_
/'
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRE~~ ~ A.LL FOR REINSPECTION BEFORE COVERING
Inspector: 'd')... \'f'l.J..M./ Owner/Contr:
CALL 447-9850 FOR THE ~EXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
lNSNOTJ