HomeMy WebLinkAboutPlg Permit 01-1343
Date Rec'd
CITY OF~PRIOR LAKE PLUMBING PERMIT
I. Blue File
2. Gold City
3. Yellow Applicant
I
(Please type or print and siltll at bottom)
ADDRESS
L,.L/D N18hi~\Q8Ltt Gall W.
APPLICANT PLEASE COMPLETE BELOW
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
Water Closet (Toilet)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
~cl 8ac\ftbaJ
(Address) IYl{10 ~ltr-;~ PJolt 1ff.
~;~~~ANT ~t)(l (h01~
(Address) llPJL4b 1vvlrJJ1J mtn
(Address)
(Contact Person) G{J)t ItA ~
APPLICANT SIGNATURE J ~ / VU.l.W'
\J
OWNER
(Name)
Quantity
PID
(Phone) ~,..5W!jt
(Phone) qC)~- ~6/ &110
lAhvl ((b fHJf)LiLf
(City) (Zip Code)
(Phone) ~1'O --~~ 711 OLQ
DATE II (11Lo 1
Type of Fixture
t
Rough-ins
Wate~~t~! _
("Water Softng...-/
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
Industrial, Commercial & Multi-family I % of job cost with a $39,50 minimum Residential, New One & Two-Family $99,50
Residential, Additions & Alterations $39,50
Estimated Cost $
Building Permit # (J / - a 4-"3
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
This APPp~Y ou, Buildiug pe,;: ;'~e.~pp'oved
Building Official Date
39.57)
.50
4'd .rJ7)
,
pai40. o-cJ
Date
/1- z,g- 0 ,
Receipt ~()154--
B' _
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
r
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
J... 8-02., 3; 00
144-70 )./ / CiHr/ N (j I't LE'
SCHEDULED
OWNER
CONTR.
PHONE NO.
J .- /34-3
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
)( H30 ~()f"I
m - 8eCj- &SCj4- .
COMMENTS:
~Q~
ror- IUit'i
o WORK SATISFACTORY, PROCEED
~ORRECT ACTION AND PROCEED
o COR~T , CALL FOR REINSPECTION BEFORE COVERING
~
Inspect ' Owner/Contr:
CALL -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI
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