HomeMy WebLinkAboutPlg Permit 06-0385
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
~ ~~~:~I I(';~V I PERMIT NO. {[ '-'3'~ ~--::- lJ
'; Velkm '\pplicant , ~ --'"
_(Please type or print and sign at bottom)
[ADDRESS. ,-~-------:--------~~--------------
/ifN3 'W~),ut:l ka,l ~
I ZONING (()fI1CC-'-'-:)l
I J
OWNER /V/ A
(Name) 11.lr7 /5
(2 , ,
a, rlCL
~t/iu('k-';a./
PID2C 404-. D 4- C 0 I
(Phone) 9.57-233-.07;(2 _I
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
(Address) /'1 I'-I.~
APPLICANik ~~
(Name) '. "'1111/5 .
(Address) (;/'1 \3<<1 ~ ,~V
(Address)
(ContactPe"on) a~ ~~
PPLICANT SIGNATURE "',~--=-
APPLICANT PLE
(Phone) evlZ- JCY- SZ~)
Jlutc/;'/7,SOj/} 6S35V
(City) (Zip Code)
(Phone) (;12-l6f-~/&:;J
DATE
E 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) ____n___~____
fn
Laundry Tray (I ()r 2 compartment sink -1
1_____ - Sewage Ejector
I Shower Stall , Backflow Assembly m.___~._.
1- -~--~._,-~ ----.-----.-------- --
Sinks --t- Backflow Assembly Test
Bar Sink .. Lawn Sprinkler ---~
- Water Closet (Toilet) Other ~0~ y~" s-\.... \\ --
-, --..
FEE SCHEDULE
Induslrial. Commercial & Multi-ramily I (~/o ofjoh cost with a $39.50 minimum
Residential. New One & Two-Family $99.50
Residential. ^dditions & ^Iterations $39.50
/.10/'1 a)
Estimated Cost $ _~~~___
Building Permit #
PLUMBING PERMIT FEE
STATE SURCHARGE
TOT AL PERMIT FEE
$
$
$
.;3Cjs-o
4'O'~
,50
(Office lise Only)
Date
l'
,}.I/ l)l~
This Application Becomes Your Building Permit When Approved
Paid
lei f' l'
Date
Building Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 /
16200 Eagle Creek Ave., S.E., Prior Lake, M~ 55372-1714
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
(JCD)
ADDRESS
,yt 43
CONTR.
OWNER
PHONE NO.
PERMIT NO.
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
TIME
../ :~-
~~
~
te
f~
o EX/GRAD/FILLING
o COMPL4.INT
o FIREPL4.CE RI
o FIREPL4.CE FINAL
& GAS LINE ~ T~T L....
pat l~ rL~'
COMMENTS:
~
-
=
ctG~t~
-
~
--
rr/QORK SATISFACTORY, PROCEED
A ~ORRECT A N AND PROCEED
o CORRECT , CALL FOR REINSPECTION BEFORE COVERING
Inspector:
owner/Contr:
FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CALL
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl