HomeMy WebLinkAboutPlg Permit 02-1110
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Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(Please type or print and sign at bottom)
ADDRESS
/5 Z8D
9- 9-0 Z-
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I. Blue File PERMIT NO
2 Gold City . 0'2- ,.11 I iJ
3. Yellow Applicant
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APPLICANT .^ I ~ 1f' r
(Name) H r: c \!' e () ( C:!
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(Address)
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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)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
. (Address)
(Address)
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D ,vd 'ttrct;'
,
(Contact Person)
APPLICANT SIGNATURE
Quantity
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
Estimated Cost $
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
This Application Becomes Your Building Permit When Approved
~ /1-1-(/7-
Building Official Date
ZONING (office use)
PID
3/)t,.. O/~
(Phone)
612 - (. efa
(Phone) 9?' L Yt, 9 - V t?E'J C)
L~~" ( sS-O(.j(J
(City) (Zip Code)
(Phone)k;tL )?c. ~ ~ C S- CJ '3
~ATE q -9- ()L
Type of Fixture
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 & Alterations
Building Permit # 6 t. -II f ()
31.51;
.50
1IfO. OV
$99.50
$39.50
$
$
$
pa~o. 00
Dat~rq,. 6 Z-
Re~?OI It:;
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
SCHEDULED I~~~
ADDRESS J 5"38D J:Q.....~-
OWNER CONTR.
nME
CITY OF PRIOR LAKE
INSPECTION NOTICE
PHONE NO.
PERMIT NO.
;2.-wo
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
)a(FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlN~. 'R,R 'TiT
~L~~
COMMENTS:
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/'wORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORR4~' CALL FOR REINSPECTION BEFORE COVERING
Inspector Owner/Contr:
CALL 't'~ FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY/
INSNOTl
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