HomeMy WebLinkAboutPlumbing Permit 04-0551
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CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
T C>J'V\.Xf\.'1 veo...vSlJV\.
'DO-XVU
APPLICANT f"-., IA IA .'<;. W~..J J L 1"'"'.1 ~O, ~"'"'\ I. J\
(Name) I<.JL.V'-Y\..oI<-J ((].~J. (Phone) LP_ 0 - 0 ~ ...Jd'fQU
(Address) 1.I 'y ~ RD A V- 'buJ HLL~OVl 66~
(Address) (City) (Zip Code)
(Contact Person) ~,\(Kl \l Hdcy (Phone) t.,1'd-'iSlPg-Q46?:>
APPLICANT SIGNATURE ~. ' _ ( . "l- DATE to' 6' 04
~' -
. APPLICANT PLEA~OMPLETE BELOW
Quantity 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 CIDset (Toilet)
t'?1ease ~ or orint and sim at bottom)
I ADDRESS40\ ""'\
o LU~ \\oLUwood Sf....
LEGAL DESCRIPTION (office use only)
LOT BLOCK
ADDmON
OWNER
(Name)
(Address)
\
1. Blue File
2. Gold City
). Yellow Applicant
I PERMIT NO. 04-. 05S / I
. ZONING (office"",)
PID 7_S'. ~'Z.(,. 001. 0
(phone) 9 6C>- a~lo- C>lo 88
Type of Fixture
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 witb a $39.50 minimum Residential, New One & Two-Family $99.50
Residential. Additions & Alterations $39.50
Estimated Cost $
Building Pennit # 0+.0,53>/
I Paid 4-0. (j C>
I Date {p .(0.04-'
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(om.. Us. Only)
~ This Application Becomes Your Building Permit When Approved
. r
Building Official
Date
'Qq, t:i)
.50
L-ID/{Y)
Receipt NO'4-/Pf99
By .f
o
24 bour nodce ror a1llnsp..dons (952) 447.9850, rax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
CITY OF PRIOR LAKE
INSPECnON NOTICE
ADDRESS
#'0/..2-
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
DATE TIME
SCHEDULED ~~
1.L//11o~C</<:)o.J s.,L
CONTR.
PERMIT NO.
01/ -: <\5""/
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
.)iI"1'EUMBING FINAL
o MECH FINAL
o EXlGRADlFILLING
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMME.~S: / /"\/ . tJ /' ()
/~r./c f-/otc-; hf!!t.,le~t'i-". -{by
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r-:')rL
-
~RKSATlSFACTORY,PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO/~/~jR REINSPECTlON BEFORE COVERING
Inspector. ~ Y OWnerlContr:
CALL 447.9850 FO~ THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
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