HomeMy WebLinkAboutPlumbing Permit 04-0898
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
/lease ~ or mint and sim at bottom)
ADDRESS
; ~% ~~ I PERMIT NO,/) II. ..... Oct l--}
3_ Yellow Applicant '-f 0 It P'"
37&5 J~ ~
.. ,
I ZONING (o_use)
LEGAL DESCRIPTION (olliee use only)
LOT 1~ BLOCK "3 ADDITION
.
OWNER
(Name)
W~M1
90~~ ~
mtJu h.rnu
PIo;:;$~39.s . (Jfof-. 0
(phone)
(Address)
APPLICANT / .. ... .., AJ/. L .'_ _
(Name) t--aA~ ~Uffr1 ~
, V
(Address) 1.J.1.f (p if ::z J hJ. /lh/'h. ff-,X-.
~Address)
(Contact Person) ~ A., J-f' .{i! u..,S<.d /
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APPLICANT SIGNATURE Ad ~.//
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(Phone) '1S~ P7 '1-7" tI ()
</J4~' 3-5-??d
(City) (Zip Code)
(Phone) 'f'S.:J- -i?7 i/ . /'6 {I 0
DATE ~/3L1J/Jj/
APPLICANT PLEASE COMPLETE BELOW
r Quantity
Type of Fixture
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
Type of Fixture
I
I
I
I
I
I
I
I
')J I~
1, /1
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backtlow Assembly
Backflow Assembly Test
Lawn Sprinkler (J V f)
Other
f
FEE SCHEDULE
Industrial. Commercial & Multi-family 1% of job cost with a $39.50 minimum Residential. New One & Two-Family $99.S0
Residential, Additions & Alterations $39,50
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
:3 950
.50
.l-fD ~
(Olliee Use Only)
J. This Application Becomes Your Building Permit When Approved
Building Official
Date
I paidt!O._
I Da~_9~OU
- .
ReCq~~/" ~
BYe
(j ~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372- t 714
DATE TIllE
CITY OF PRIOR LAKE ,~
INSPECTION NOTICE SCHEDULED
JJt~ 01
ADDRESS 'S'lfe~
OWNER CONTR.
PHONE NO. PERMIT NO. 'I-~
[] FOOTING [] PLUMBING Rl [] EXIGRADlFILUNG
[] FOUNDATION [] MECH RI o COMPLAINT
[] FRAMING [] WATER HOOKUP [] FIREPLACE Rl
[] INSULATION o SEWER HOOKUP o FIREPLACE FINAL
[] FINAL [] PLUMBING FINAL [] GASUNE~~
[] SITE INSPECTION [] MECH FINAL ~ J ""'u
COMMENTS:
/WORK SATISFACTORY, PROCEED
[] CO~ACTION AND PROCEED
[] COR~ ,CT roRK, CALL FOR REINSPECTION BEFORE COVERING
J
Inspector\ \ , Owner/Conlt:
CAL~Il.9850 FOR THE NEXT INSPECTION 2. HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
1lGNOt,