HomeMy WebLinkAboutPlg Permit 02-1587
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File PERMIT NO t1
2. Gold City .~ I~
3. Yellow Applicant (...b< I C;; (
(Please type or print and sign at bottom)
ADDRESS
I "73S0 W',)010 Lanf- S. vJ I
.
ZmG (office use)
/ ~
LEGAL DESCRIPTION (office use only)
LOT9 BLOCK'! ADDITION !J/~tLJ;) 6--0..
g;:r::R ~s: Sc<-\ 'y
(Address) I t,rgS-O Lj i JJCIJ,j Ln. .s. w.
~;;~~ANT~orb\O'M P\UW\b\~
(Address) 2<7/)5 UJuke Jc1 lfve. ~.
(Address)
PIDdS -;}lI [-030-0,
(Phone) (~5Z) 1'-1D - 7'100
(Phone)
Mf\S
(CIty)
(ft,12)827- L/a33
55L/1) K
(Zip Code)
(Contact Person) (Phone)
APPLICANT SIGNATURE ~ ~ DATE
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (1 or 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
12/~jI)L
Quantity
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
lndustrial, 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 $ 't Ill> ~
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
:SCC. SO
.50
'-/() - 00
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid L/O I _
Building Official Date J Date /~//o/OJ-.
24 hour notice for all inspections (952) 447-9850, fax (1s2) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
Receipt lt3 '70;),
By
or~
iJ
DATE nilE
CITY OF PRIOR LAKE
INSPECTION NOTICE
I
SCHEDULED
"( -1-0
.
ADDRESS J <6'S-O U/< flllw L"'-<.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
-2-/r-~7
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
Hi-a I-!-t: Ol L r
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
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~KSATISFACTORY.PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: rrf -] j,,()- r.J!> OwnerlContr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSIIOTI
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