HomeMy WebLinkAboutPlg Permit 04-0932
CITY OF PRIOR LAKE PLUMBING PEAAt..
Date Rec'd
ti",r-.A4-
/,---"'~...
.;lease tvDe or Drint and SilUl at bottom)
. ADDRESS
/l.fltto
L.\.h\ JSQ\V..J t\1W
LEGAL DESCRL.t' nON (office use o!11y)
LOTfrcY BLOCK (p ADDITIQN 11~ WlV'J.l
Ii
OWNER
(Name)
I') () "'+
cCil<M /.h.,
(Address)
APPLICANT
(Name)
(Address)
i ~~ ~:~ I PERMIT NO.O'f. OQ.3z..1
3. Vellow Applicant f'
ZONING (office use)
PID z.f".. z,q 7 . 0 (,8..0
(Phone)
r:-Ul.LIGAN WAlEf1'. (Phone)
. 6030 CULl'G~~~~~ON/NG
(Addres$)~cIUNKA, MN '55345 (City)
(952). 933.. 7200
~PLICANT PLEASE COMPLETE BELOW
Ty" of Fixture Quantity
Bath Tub with or '\jfIithout shower
Dishwasher
Floor Drain
Lavatory (Bathrooin Sink)
Laundry Tray (lot 2 compartment sink
Shower Stall !
Sinks
Bar Sink
Water Closet (ToHret)
(Contact Person)
APPLICANT SIGNATURE
,,--
Quantity
FEE SCHEDULE
Industrial, Commercial & Multi-family ~ % of job cost with a $39.50 minimum
(Zip Code)
(phone)
DATE
Type of Fixture
I
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated tost $ go 0 ~ Od
Building Permit # d 4--. d 9.:12-
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Bpilding Permit When Approved
,,-~
Building Official
Date
"3~. p>
.50
" 0 l oJ
Paid 4'0 -' C/1J
DateA , .L-
7d(,,,. r
Receii;1NO. +7810
if'
24 bour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
DATE TIME
CITY OF PRIOR LAKE '1-'1, Y:5! !
INSPECTION NOTICE SCHEDULED
ADDRESS m~O W..~ fliP~I)
OWNER CONTR.
PHONE NO. PERMIT NO. t! -? 3'2
o FOOTING o PLUMBING RI o EXlGRADIFIWNG
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE Rl
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL Ii o PLUMBING FINAL )'~~~AI~ .
o SITE INSPECTIO, o MECH FINAL
COMMENTS:
/
~ORKSATlSFACTQRY,PROCEED
o CORRE CTION AND PROCEED
o COR CT K, Cl\LL FOR REINSPECTION BEFORE COVERING
Inspecto . ~ Owner/Contr:
CALI: ~850 F~ THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE ~1NTSARE FOR YOUR PERSONAL HEALTH cl SAFETY/
IN8NOTl