HomeMy WebLinkAboutPlg Permit 01-1428
CITY Oli' PRIOR LAKE PLUMBING PERMIT
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12,.
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LOT BLOCK
~WNER_ ---
4~me) 7 "." '1
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(Address) J IP ~7
ADDITION
~: ~~ ~~~ PERMIT NO. ~/_I/ /7t:2.1
3. Yellow Applicant Iv ...,.,~
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fONING (office use)
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PID 25-/83- (jUS...J
(Please type or orint and silm at bottom)
ADDRESS
114' +-57 rlv6 rt?9w,t::;r'
LEGAL DESCRIPTION (office use only)
~ WLA V\(./)rJ
H.Je'. J..kt w~ ~ 4v~ _sf.
(Phone) tj 5'..:2 - ,t/~7-.~5 b
APPLICANT
(Name)
(Phone)
(Address)
(Address)
(City)
(Zip Code)
(Contact Person) (Phone)
APPLICANTSIGNATU~~~ ~t-~~~?- DATE V' 1:2-,;'?<8"-o I
{/ / -
APPLICANT PLEASE COMPLETE BELQW
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 REQUEST FOR INSPECTION
Water Closet (Toile SENT TO HOMEOWNER 2/03.
NO RESPONSE. CLOSE FILE
(
Quantity
Type of Fixture
r
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewa~e Ejector
Backflow' Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
idential, New One & Two-Family
Residential, Additions & Alterations
Building Permit # 0 / .- 1428
.:J;> 9, so
,50
~r)
$99.50
$39.50
Industrial, Commercial & Multi-family 1",-0 UIJUU w.n ...... _ .__.. _ ___
Estimated Cost $
$
$
$
(Office Use Only)
Thd APPlic?}#1' YOD~ BDUdiDg 7;~~; ;Ted
Building Official Date'
Paid ~ . cfl)
Dat1z.-_ ?f;-O /
Receipt ~I / z,~
B~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDI !LED
ADDRESS
/ft, '1S7
~
OWNER
CONTR.
PHONE NO,
PERMIT NO,
o FOOTING
o FOUNDATION
o FRAMING
o INSULA nON
OCFINAL
b SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
DATE TIME
IA~'l- /J:bO
~
tJ(-/J./~
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS: ~ -;/~,
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o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
~ CORRECT WO~LL FOR REINSPECTION BEFORE COVERING
Inspector: ,. ~ <.. Owner/Contr:
)
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl