HomeMy WebLinkAboutPlg Permit 02-1329
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(Please type or print and sign at bottom)
ADDRESS
11873 Pixi-t.. ?oInt Crc/~
I. Blue File PERMIT NO
2 Gold Cjty '/} 1_ / ::2 "'1 (),
3_ Yellow Applicant Vl?\ /~7
ZONING (oftice use)
S.E.
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID,~j -; ~atJq ""L/ i4-(j
~~e~R \Jf)sc~(fcd
. (Address) /L/~7.] :Pi x:.i e hint Clyde
(Phone)
(<=152) '110 --21/~
S.E.
APPLICANT ~ \ \_ 1'\
(Name) NOf\u\OW\ r\~~~
(Address) Z '::;05' &t2-1rLe.ld /In;Q.. So.
(Address)
(Phone)
[V\p \ ~
(City)
( ~ I 2.) 't 2 7 - 0/033
55'10'8
(Zip Code)
(Contact Person) (Phone)
APPLICANTSIGNATUR~ ~~ _ DATE
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)
~ /:1,,/OZ
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 $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
3'1 5:7J
.50
'-/0. 00
(Office Use Only)
Building Official
Date
Paid ,. ___
qO.
Date
/0 /0. (Jer
Receipt N?") c>"7 ('.'.;7'
I./~ /
By ~~
v
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave" S,E., Prior Lake, MN 55372-1714
CITY Of PRI(!:\R' LAKE
INSPECnON NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
/ /9/ ~Ej.. . ~ME
SCHEDULED ~7--
L 87 S My {e ~- Cll~.
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECHf7rIN L
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!...JA":;:CIL-' . ~
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1?7 _ 13.'7
I
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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c..
, ( ,;,-tt.../f../ c......
l~ I L-e-~
r
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
C 1/
Inspector: ~ , Owner/Contr:
-"
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOT/