HomeMy WebLinkAboutPlg Permit 06-0929
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
PO c.k.tt
:3 \3 Y-:b
; ~~ ~:~ I PERMIT NO./. - 0./ <::'41
3 Yellow Applicant , (12. L V I
I ~';;;:;s~ print md ,ign -!t bonom)
lla04~ LJp>4 Ave, S.E.,
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
I
\'
PID
OWNER
(Name) ~()I/H'l'"
G; r'OVV\ ) e:J
\.....)QS+ Ave..
'S,B,
(Phone) 11LD -8lS l- l.24n
(Address) I lP04 ~
e...
APPLICANT
(Name) F'a.~vv1" t''-
(Address) lD3 . h;
(Address)
(Contact Person) 0~ 't"V""'I rp~V'\ ,
APPLICANT SIGNATURE -=rJ~ l.- ~
,,\ -.L.~ \0 "~ &2 ~~ (Phone) le5 \- -' ~ ~5 ~ 7~ <<r
I A t=tlf"v'Y' In 40~ N\ ~ 50:1.
(C ) (Zip Code)
(Phone)
DATE
}D~q-O<.o
APPLICANT PLEASE 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)
Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) \ Other ('f> ('\ \cu e.... wlH
T 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
Building Permit #
Estimated Cost $
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
,~9, 50
.50
YD,OD
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid 0/), .~
Date
Rece. ipt No. q
/~ gr'
By
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, M~ 55372-1714
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
/O/M-01b
ADDRESS
/(,(Ny IMs~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
&. 92. r
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
o PLUMBING RI 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLlNE AIR TST
o MECH FINAL 0
/1J-6 I~t--( f-v,
~WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PRO
o CORRECTazOR "
Inspector: Owner/Contr:
,
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI