HomeMy WebLinkAboutPlg Permit 06-0863
Date Rec' d
CITY OF PRIOR LAKE PLUMBING PERMIT
?Z~X
I. Blue File PERMIT NO.()/-.OI!J./ ?
2. Gold City ~ {;iI(.JZ.:J
J Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS
"3" I (, f~)C J-",; ( C (j~'.f fJr &J /'
, ZONING (office use) ,
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
(Address)
c\-~
]~ (~
11:) ~ \
fo'r- f-<(' {
c
\ ~'C<
(Phone) b {J r;'( D - 3 ~b
OWNER
(Name)
/V. V
(Address)
5... \'7.AJ' f ~",~1 ~^)
~ S- 4 ~ I Yl 1'''- s .-f.
(Address)
w
s. \/-1......
(City)
(Phone) -LJ ] - aO (,- ~7-() b
DATE 9-)- 1- .-<::) 0
.iG:
(Phone) l' f) - ~"\ '7 . J S-
&"53/6'
(Zip Code)
APPLICANT
(N ame)
(Contact Person)
LJ~
t\PPLICANT SIGNATURE
fiJ ~J-
J+
Quantity
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity I Type of Fixture
Bath Tub with or without shower I Rough-ins
Dishwasher Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (1 or 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other cJv...,: u
I
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~~v
.50
~.t1d
(Office Use Only)
,
Receipt NO~ ~2...~
By ~_ '
,
This Application Becomes Your Building Permit When Approved
~ ~ 9/z,~,
I Building Official Date'
Paid
~. 1J1J
1/~'
Date
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
ADDRESS
3~ l<.e
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
I OAT'
SCHEDULED 1/2c;/6tP
-c~l /
TIME
CONTR.
PERMIT NO.
v
et t2,)
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
.1'f GAS LINE AIR TST
oDf"jer-
-
If '\
(\ / /
\j\~ ,./LD
J - -
~ORK SATISFACTORY, PROCEED
o CORRECT :rION AND PROCEED
o CORR" K CALL FOR REINSPECTION BEFORE COVERING
Inspecto : Owner/Contr:
C 7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
~CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI