HomeMy WebLinkAboutPlumbing Permit 03-1016
DATE TIME
CITY OF PRIOR LAKE r?-/f,f
INSPECTION NOTICE SCHEDULED
ADDRESS /Ltf./.G ( C4Si-t" 1"." L
- .
OWNER CONTR.
PHONE NO. PERMIT NO. ".?-//Y{A
o FOOTING o PLUMBING RI o EXIGRADIFILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL o GASLlNE AIR TST
o SITE INSPECTION o MECH FINAL 0
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~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~~;.BL FOR REINSPECTION BEFORE COVERING
Inspector: JI V r. ~ r I Y" VZner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETY!
INSNO"
. Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
l. Blue File I PERMIT NO 4
2. Gold C;'y .' /1:::2-/0"
l. Yellow Applicant U J - _ l
~lease type or orint and sign at bottom)
ADDRESS
/YC/6/ (~ffdb/f7i' ?Jh'Y
ZONING (ollicellS')
LEGAL DESCRlPTION (offie. use only)
LOT:"-30BLOCK I ADDITION YJ2.g~1A) V.-LU.Y
PID.:l5 -- -381{- o30'()
OWNER
(Name) 1///1 /t-t IF..
#Nt v,{:Rf,JA/
(Phone) 9S',;. - </<J5 - /60JY
(Address) /'/~6/ ('/ls7d6/i'7'%. //)'A Y
APPLICANT '~J?" /1/ n /
(Name) UI/VC..5/M '<'-0 1:>
(Address) /..JVb7 ?j.de//~
(Address)
(Contact Person) '("'A~ L
_. \PPLICANT SIGNATURE d/ 7:?~
I Quantity
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@-. ///,{:
At./~
(Phon~) 9.>..:2 - 5'>'9"" -7Coo
5/lt/4'64, MAl S-SJ).F
(City) I (Zip Code)
(Phone)
J-'/-l
7A~'/o.J>
DATE
APPLICANT PLEASE COMPLETE BELOW
I Type of Fixture I Quantity
Bath Tub with or without shower Rough-ins
I Dishwasher . Water Heater
I Floor Drain I Water Softner
I Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 compartment sink I Sewa!\e Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
. Water Closet (Toilet) I Other
Type of Fixture
FEE SCHEDULE
Industrial, Commercial & Multi~family 1 % of job cost with a $39.50 minimum Residential, New One & Two-Family $~
\, L Residential, Additions & Alteratio~
Estimated Cost $ _~-::' Building Pennit #
'-0
"7 C ~
-, 7.
,50
<1 D. .,...,
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
paidt(Q. --
Date R~{r?J
~e~elf1[Jg g~
B3
Date
24 hour notice for all inspeclions (952) 447-9850, fax (952) 447-4245
t.