HomeMy WebLinkAboutPlg Permit 01-1412
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File PERMIT NO I
2, Gold City '01-1 J/'
3, Yellow Applicant ~ '-
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
3.3 ) Lj L~ IA)(N(: //1 '- t7 S t>
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LEGAL DESCRIPTION (office use only)
LOT6BLOCK'Z..- ADDITION ~(""""tVW.4n;12.. 7____t1:!2 Aoo PID 2"::;"'~""1..ol'..o
OWNER
(Name) tv Y1L1/f/il ~I/\
cCHPLf:
(Phciie'V l.J I .L 1 ~ CI 7 r!J I .l-.
(Address)
APPLICAN:h J /) L /. j) (
(Name) i~ 01J ~t.,( -401lid
(Address) (E.) 0 LtLLtfL rH N, rvlt; ~
(Address)
(Contact Person) _ f.rrr.:'4.t~ -
APPLICANT SIGNATURE ~?vl~J~~ft(
(Phone) 61). ~J Y (gS-:-;' (;
(City) (Zip Code)
(Phone) JL) ~3 V <~ 2. ?:~
DATE JJ- 17 7} /
Quantity
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity I Type of Fixture
Bath Tub with or without shower I Rough-ins
Dishwasher I Water Heater
Floor Drain I Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink , Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
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 #
(Office Use Only) L 1"
Thl'APPI~~'
Building Official
$ 5'1....;-0
$ .50
$ +0. --
Paid
40. --
Date, '7_/' 7 ~,
,
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
Receipt N~ ,
c.r l 0'7
By ~/-J.
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ADDRESS
:, 3 14-
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b{~ ~ Wa1-u-
CONTR.
OWNER
PHONE NO.
PERMIT NO. t9 ( - 14(02.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION ~ SEWER HOOKUP
o FINAL ~LUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
50!; tev\eA'
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
/
COMMENTS:
/WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR~, CALL FOR REINSPECTION BEFORE COVERING
Inspector: :t) -l C/..J.JI! Owner/Contr:
CALL 447-9850 FORhHE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTJ