HomeMy WebLinkAboutPlg Permit 02-1496
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File
2. Gold City
3 Yellow Applicant
PERMIT NO&r1_ /l/1to
ZONING (office use)
E/50
(Please type or print and sign at bottom)
ADDRESS
3i S7 tAli II 01V beach '--{Va; IS. t,V t
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION f f'tl[;f- P .J?LS #- 3 ff
,
PIq;9S.... /()'l-oo~-()
~=~R 15VJ{\(e_} FdwOJCd
(Address) 3'-/57 Wi JIIW ~~ Ir-. S.W.
(Phone) lqsz) 1,-/(J ..crfz,!
APPLICANT\. \ b\ ~\ \ ..
(Name) 1\J Of' (JYV\ r \}..NV\D IV\~
(Address) 2<jO~ 6tl./V.{:,~/d 4~. <"&0.
(Address)
(Phone)
Mp'~
(City)
(fo\2)821-cJ633
5s'lo8
(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)
/'/3 ~z..
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
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 $ 'ftJ7J !:?
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
3&f.SD
.50
L/f) . () ()
(Office Use Only)
Building Official
pai~O ,OV ReceiPiI}q 6 ~
Date II-lJ-j....{JrfiY ~
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
This Application Becomes Your Building Permit When Approved
,.
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
11-11-
1//;
ADDRESS
~c..1S7 lA/illiftv .~rr;(;J1
..;
OYVNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
CONTR.
PERMIT NO.
&- /4'.}) "'
o PLUMBING RI 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
o YVA TER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLlNE AIR TST
o MECH FINAL 0
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/ I,or ~
L,....-tV/ L
t-: ~
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~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRE~ m CALL FOR REINSPEcnON BEFORE COVERING
Inspector: JJ![ / (-L(.....()" Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
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