HomeMy WebLinkAboutPlg Permit 02-1330
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File
2. Gold City
3 Yellow Applicant
I PERMIT NO.O~-!39()1
(Please
ADDRESS
ZONING (office use)
11/10 WddeKY\e-ss ~cU\ S~
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
DO\. \/\c..k . J o~V\.
I
/7/70 JV;lo/f#'n~$5 j;-~/ <;.6.
APPLICANT l \ L\ Ul L
(Name) '''-'OfO\OW\ '\ l.,.lAMU\'^Q
(Address) 2~()fi utvr.f;.e Id ~e-. So.
(Address)
(Address)
OWNER
(Name)
(Phone)
(Q5Z) "t/()~Lj1JC>
(Phone) _l (",'2) 82 7 ~ tj033
Mp\s 5510g
(City) (Zip Code)
(Contact Person)
(Phone)
APPLICANT SIGNATURE
DATE
?/1()~2
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink I Lawn Sprinkler
Water Closet (Toilet) 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<'J . bO
.50
'10 . 00
(Office Use Only)
Building Official
Date
Paid
tfO.-
Date 0 ./~ . /),'
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
0" TE 'TIUE
I Of PRlOR LAKE
INSPEC1'\ON N01'\CE
SCHEDULED
~
---
~DDRESS
O....ER ____ co1<fR.
p>lONE NO. ~ PERMIT NO.
o fOOTING 0 PCU..BING RI
o fOUNOA liON 0 ..EC>I RI
o f.......,NG 0 "'A'ER >lOOl<UP
o "'SU'-" liON 0 sEV'E" ,.ool<Uf
o fl""C 0 pt.U..BING flNAC
o 51'" INSPEctION 0 ..EC>l flNAC
t 7 ('70
wi fJ,J",~95 1>-~; I
L-4.w.
~
a ~GAADJf\LUNG
a COtAPV-\N1'
a f\REPV-CE R\
a f\REPV-CE f\NAL
a GASUNE AiR 1'S1'
a ____
~..(~t.-
COMMENtS:
'I'llOM" '1S..C10R~. PROCEEO
a CORREC1' AC1'\ON AND PROCEED
o co_ct'llOR"- Ace fOR RElNSPEctlON BEfORE Co",""NG
IO'pec\<>c q,(61Jl, """."c""... ~
CACC ..1..... fOR '{tiE NE'" INSPEcnoN .. >lOURS IN Af1'lANCE.
CODE REQVIREMENTS ARE fOR yOVK PERSON'" /lEAl-VI .. sAFErr'
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