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HomeMy WebLinkAboutPlg Permit 06-0528 Date Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT (please tvDe or Print and sie;n at f. .".".".,..) ADDRESS It/oSS' 1-ba"~L.je Cl??t ~: ~1w E- PERMIT NO. 0 rv -5 ~S- . ZONING (office use) LEGAL DESCRlr liON (office use only) LOT 1 BLOCK I ADDmON (j/.d!c0 17~ PID 36 -l( 04 - cJc/) -{ I OWNER (Name) 'h-en~~ (phone) crs 2 - tKJ3 - 9/5-1 (Address) ~ ~E..t\hE- (phone) lo \d - ~O\ -6dIoO (~@ ~ 5\kj \-\Ll.t~ 55\i5D (Address) (City) (Contact Person) \J{;. ~ k'i \5 (Phone) APPUCANTSIGNATURE ~ ~ ' U\..... DATE " APPLICANT PLEAsEko-MPLETE BELOW Quantity Type of Fixture I A Quantity Bath Tub with or without shower I Dishwasher I Floor Drain I Lavatory (Bathroom Sink) I Laundry Tray (1 or 2 compartment sink I Shower Stall I S~ i Bar Sink I Water Closet (Toilet) I FEE SCHEDULE Industrial, Commercial & Multi-family I % of job cost with a $39.50 minimwn APPLICANT (Name) t'\ ~"-.)~\~ (Address) l a \ L{ (Zip Code) Type of Fixture , Rough-ins Water Heater Water Softner Stand Pipe (Washin~ Machine) Sewage Eiector Backflow Assembly Backflow Assembly Test Lawn Sprinkler . Other (Office Use Ooly) Residential, New One & Two-Family Residential, Additions & Alterations Estimated Cost $ loOQQ. Building Permit # PLUMBING PERMIT FEE $ ,3Q . 50- STATE SURCHARGE $ ..50 TOTAL PERMIT FEE $ Ll U .00 $99.50 $39.50 This Application Becomes Your Building Permit When Approved Paid if 6", ~ Receipt N~) IIJCf3 Date Date / - jq - I( Br'_ BoUdin!!: Official (p <.D,~ 24 hour notice for aU inspections (952) 447-9850, fax (952) 447-4245 t/ 16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714 CITY OF PRIOR LAKE INSPECTION NOTICE ADDRESS f l( c./)r\ OWNER PHONE NO. o FOOTING o FOUNDATION o FRAMING o INSULATION o FINAL o SITE INSPECTION COMMENTS: o (b~P_ SCHEDULED (-tou-s lk IF DATE TIME 1~6~ 1..0 - 5;<8 o EX/GRAD/FILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST J3'.- l....-.'^- 3: or (<;. ,J '?...... u ~ORK SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED o CORRECryY~OR REINSPECTION BEFORE COVERING Inspector: (( ! / Owner/Contr: CALL:J7-9~~;;OR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CONTR. PERMIT NO. o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL " ~. ~?-V CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! INSNOTJ