HomeMy WebLinkAboutPlg Permit 06-0889
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
(Please type or print and sign at bottom)
ADDRESS .
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LEGAL DESCRIPTION (office use only)
LOT
ADDITION
BLOCK
OWNER
(Name) LeOY)41 d
(Address) S ~
Brown
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APPLICANT l LAn p \, - (I.lS
(Name) n t" ..It ~AJO J-
(Address) ?it, 10 t;6dd tz d
(Address)
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; ~~~ ~::y PERMIT NO. At, . OIJ./J./)
3 Yellow Applicant U 0'(;1"1
I
ZONING (office use)
(Phone)
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PID
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(Phone) ~ - ?M5 -I!JJ 0
filSCU\ fAN. SS\;):;
(City{ (Zip Code)
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'1- (7- () 6
(Contact Person)
APPLICANT SIGNATURE
(Phone)
DATE
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
Quantity
FEE SCHEDULE
Industrial. Commercial & Multi-family 1% of job cost with a $39.50 minimum
Estimated Cost $
.]00,00
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
Residential, New One & Two-Family $99.50
Rcsidential. Additions & Alterations $39.50
31'~o
.50
~v. On
Paid
+04 Of)
/0,3" oft
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
A
Re~t No.
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CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
IS-47S---
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
SCHEDULED
(l/'e-e-z'1
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS: H2o t+t:IXfe_
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DATE TIME
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o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PRO D
o CORRECT WO REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl