HomeMy WebLinkAboutPlg Permit 06-0925
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
10. /2. Ob
I Blue File PERMIT NO. ()~. 0 925.
2. Gold City
3. YeJlow Applicant
(Please type or print and sign at bottom)
ADDRESS
35.s-9 /J~/9NO
vIE- W G/K-.
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID 2-5. /8cr. 003, ()
OWNER
(Name)
(Phone)
(Address)
APPLICAt c. '\ Fr ("
(Name) . {' kJ ~\ ~
t.k~ '4
(Address) \ S O(}- \ fV\ CI ~"- {P.
I (Address) (City)
(Contact Person) _. ~6 LJ--z.... (Phone)
APPUCANTSIGNATURE y,{ ~ 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)
(Phone)
Cf1d. \.f.t{,- ?~J-
{2-D
~
(Zip Code)
lO-D{)(O
Quantity
Type of Fixture
V/
V
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
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 $
39.50
.50
40.0~
(Office Use Only)
Building Official
Date
Paid ~ j nJ
Date / 0, Iz,,~ ()/,
Recito. 52A19
BY.t .
o
,
This Application Becomes Your Building Permit When Approved
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 .<t5,~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
~~ fhr:;:.~j
C',/~
DATE TIME
SCHEDULED ~~~
Ss~ 'J l~ CM..
CONTR.
PERMIT NO.
(/ -1'2<
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
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In n (
\t\DI ~"-- / ~ (J
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..x(y.tORK SATISFACTORY, PROCEED
"'?-- CORRECT ACTION AND PROCEED
/ 0 CORR 0, ALL FOR REINSPECTION BEFORE COVERING
Owner/Contr:
C/J\. ,L 1" - 50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODi-JEQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSHOTl