HomeMy WebLinkAboutMech Permit 02-1329
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Date Rec'd
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CITY OF PRIOR LAKE PLUMBING PERMIT
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(Please type or print and sign at bottom)
ADDRESS
/1873 Pi;<i-t. {1;it1t Wrcl-e. 5. E.
I. Blue File I PERMIT NO
2. Gold City i?.l"'l_/~""'~
3. Yellow Applicant 1:;1\ =-' C!l"-"7
ZONING (office ~slh
LEGAL DESCRIPTION (office use only)
LOT . BLOCK
ADDITION
PID
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APPLICANT l \ L \ D
(Name) NOf UV1'YV\ "\ h..l-'\.M.~...~
(Address) L" 0 5 &a.v- .[i.e ld !tv Q . Sc),
(Address)
(Phone)
(V\p \~
(City)
((,12.)~27- "03]
55'90'8
(Zip Code)
(Contact Person) (Phone)
. :"'._~_ 'PLICANT SIGNATUR~~~<,"" ".10 < --..... _~-:- DATE ~ .4~/o.z
'. APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture I Quantity Type of Fixture
Bath Tub with or without shower I Rough-ins
Dishwasher I Water Heater
Floor Drain I Water Softner
I Lavatory (Bathroom Sink) I Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 compartment sink I Sewage Ejector
I Shower Stall I I Backflow Assembly
I I ~inks _ I.- I Backflow Assembly Test
" -., j""" "" ,.,,,..,,,~,,,;,,.,-,..,..... 't''b'at''Sin~'''''''''''-''''_:*'''~'''''>';' "'" ....:. ,...,"';;: "-'.. ""::-~-'f*':- -'~f":"" :,.,....4~ :-'~41,'ba",*.~prinkier..;;-.~;''''' ;-:Jfv.",... . :o:c "~:7""'''''''''-'-
, . I Water Closet (Toilet) I I Other
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FEE SCHEDULE
Industrial, Commercial & Multi-family I % of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Penn it #
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(Office Use Only)
:his Application Becomes Your Building Permit When Approved
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMJT FEE
$
$
$
3~,!;7)
.50
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Building Official
Date
Paid __
t./Z; ~ -
Date'
/0 . /6. tJ?r
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ReceiP'l)J.R71
By ~
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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
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
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{J~.~
ADDRESS
t 4lb,3
OWNER
PHONE NO,
CONTR,
PERMIT NO. J- -l "3 Z'1
o FOOTING 0 PLUMBING RI 0 EXIGRADIFILLING
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULATION A 0 SEWER HOOKUP 0 FIREPLACE FINAL
o FINAL J# PLUMBING FINAL 0 GASLlNE AIR TST
o SITE INSPECTION ~ MECH FINAL 0
COMMENTS: ~O~~ ~A* J- [^J~l~,
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspectoc ~ OwneO'Conlc
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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