HomeMy WebLinkAboutPlg Permit 05-0077
CITY OF PRIOR LAKE PLUMBING PE~ll.l
Date Rec'd
/. 3 J . 65"'
~.:':: ~~~ I PERMIT NO. 05'_. 0071
3. Yellow Applicant -
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ADDRESS
""l ~ 1 D 'Pllr\C ~1 \ L V \~t-
~ SE
ZONING (office
use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK
ADDITION
PID z5. :;ql . 601.0
OWNER
(Name)
'7~ \V\G
(Phone)
(Address)
APPLICA~" D 1 _' . n l . I"
(Name) (~\ (VyrLl\dM-r tUl l-J( (Phone)1lf"1 ~r ,~U LP ?J
(Address) 'ME:\ rOY\ltqVet'J (\' r[)< :W~DO ~me.V~ S~ 3J*
~dr~ssf - (City)) (Zip Code)
()S\f\ rvt.. V (Phone)
APPUCANTS1GNArum.. k..,.>H_ '11i:Lt~ATE
. APPLI~ANT PLEASE COMPLETE BELOW I
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain C IQ yo JS"~n
Lavatory (Bathroom Sink) -
Laundry Tray (1 or 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
'Contact Person)
,!;u b~
Quantity
Type of Fixture
J
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washi~ Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other D~ I1.fZ.
J
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 $
(}s:.0071
.50
'/fl. 'iV
(Office Use Only)
.J Tbis Application Becomes Your Building Permit When Approved
#//~ ~/y/b.s-
I Buildinl! Official ' Dite
Paid ..3' 9. 5V
Date z,. ~,os-
ReceiptNo:f e(;B~
By l&i
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
INSPECT10N NOTICE
ADDRESS
761'CJ
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
DATE TIME
SC~EDULED /If(~'-
/1,1 ~O//~ I
CONTR.
PERMIT NO.
~LUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
~UMBING FINAL
o MECH FINAL
5-71
o EXIGRAOIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMM.E;NTS: /' / /I ,,/1 I A
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~~~~~ .aAV PRa~~~~
o CORRECT ACTION AND PROCEED
o CORRECT WORJ-,;.?yHNSPECTION BEFORE COVERING
Inspector: j ~ / .____Owner/Contr:
r
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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