HomeMy WebLinkAboutPlumbing Permit 04-1011
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
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LEGAL DESCRIPTION (ollice use only)
LOT 4 BLOCK J- ADDITION W I fA) f ~
OWNER
(Name) S"".... .n
ke--J /y
4ft '/ d. Jlt:> rse
~ss
(Address) ,~~~~
APPLICAN~ 1-. I I
(Name)_~/ct.-
(Address) --3J ~
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(Address)
(Contact Person)
APPLICANT SIGNATURE
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10.&.04-
;:~ ~:~ I PERMIT NO.O 4-./011
3. Yellow Applicant
ZONING (office use)
14
PID -u:-. 37f!>. OsS- 0
(Phone)
(phone) 7.(3- "I'7:S=-oz9~
P/YhlOVrh S~t,lY7
(City{ (Zip Code)
(Phone)
DATE
'1- '2-9 - O~
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)
j
Qnantity
FEE SCHEDULE
Industrial, Commercial & Multi~family 1 % of job cost with a $39.50 minimum
Estimated Cost $ L./6JC). OC>
I
Rough-ins I
Water Heater I
Water Softner I
Stand Pipe (Washing Machine) I
Sewage Ejector I
Backflow Assembly Yt:U..rJ_tJM ~
Backflow Assembly Test +cs>)- . I
Lawn Sprinkler /t-rt'ia....;hCW1
Other <'V~-TePl I
,
Type of Fixture
I
Residential, New One & Two.Family $99.50
Residential, Additions & Alterations $39.50
Building Permit #
04-.lfJ//
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Olliee Use Only)
) This Application Becomes Your Building Permit When Approved
Building Omcial
Date
..........__ ..........J
39..SO
.50
~~.OO
Paid
Receipt No. 1I-"19!?tJ
By
~,(A)
Date
10.&." I-
I/HL-
I
24 hour notice Cor all inspections (952) 447-9850, Cax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS 3S <-N
lJ:kO
~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
DATE nIlE
!#t(
e~
4 -IDII
o EXlGRADlFILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASlINE AIR Tf1( r _
)i LA-. J~~
/
1'<.)
. )
~
kRK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o COME."-RK. CALL FOR REINSPECTION BEFORE COVERING
Inspector:tJV7 Owner/Conlr.
CALL 447.9850 FOR THE NEXT INSPECTION 2<1 HOURS IN ADVANCE.
........
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & 8A.FETYl