HomeMy WebLinkAboutPlg Permit 02-1450
Date Rec'd
CITYO}' PRIOR LAKE PLUMBING PERMIT
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(Address)
(Contact Person) -fJlttl( ()1 oorZr
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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)
(Please type or print and sign at bottom)
ADDRESS
5b)0 Fox'7A/ I
TMil
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
w E rJ S f'I1A (V rJ
(Address)
APPLICANT 1J
(Name) Iv/oollE
(Address) /033'
APPLICANT SIGNATURE
Quantity
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1. Blue File PERMIT NO
2 Gold City . A Z ..../' A r'11
). Yellow Applicant U q'..:;:JU
ZONING (office use)
PID
(Phone)
(Phone) 76 "3 .- '3?9 - .2r;z (
ffZlvGE.fo~ .~'J7/
(City) (Zip Code)
(Phone)
7b?- :2~6 - 0 f~r
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DATE
Type of Fixture
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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
Estimated Cost $
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Building Permit # ~ - /4-5V
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
3'9.,50
.50
4-0. c/O
(Office Use Only)
This Application Becomes Your Building Permit When Approved
~ 16~:l'~O7-
Building Official Date
Paid +0 of 6b
Date
(<i-1 f--o"L.
Receipt N~3l....3 4-
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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
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED I' -4' - C~
/0:10
ADDRESS J~SO
fix +0.,\
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
O"J. - ,c./ SO
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
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
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COMMENTS:
./
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
ORK, CALL FOR REINSPECTION BEFORE COVERING
Inspecto:
1 Owner/Contr:
'~9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
QUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl