HomeMy WebLinkAboutPlg Permit 01-1331
I. Blue File
2. Gold City
3. Yellow Applicant
Date P,fc'u
'~~~;.
,ii~
i"
CITY OF PRIOR LAKE PLUMBING PERMIT
(Please type or Print and sign at be
ADDRESS GAJRIA, LEAH
( 16261 EVANSTON AVENUE S.E.
PRIOR LAKE, MN 55372
(952) 226-3099
LEGAL DESCRIPTION (olllce use only)
LOTU BLOCK
I
ADDITION
PI0.:?5 -ml- ({)g-I
OWNER
(Name)
L-t:A~ GA"5f-1 A
Ifo l0/ tVAtJ~IDI\1
(Phone)
CfSL,-~Lb- s6q~
(Address)
Nt- :;,6.
APPLICANT
(Name)
(Phone)
(oIL g 2-7 t./ rP;--:s
Quantity
NORBLOM PLUMBING' CO. "
E D'..~U.. II
-
rs. MN S54~
J it ' (Phone) I,
ry~ DATE ~/!)1
~LICANT PLEASE COMPLETE BELOW
Type of Fixture I Quantity Type of Fixture
Bath Tub with or without shower I ..----- frt1:.:o~' :"'~
Dishwasher I <... 1 Water Heater '\
Floor Drain ---- W <1lt:1 sonner -
Lavatory (Bath~oom Sink) Stand Pipe (Washing Machine)
Laundry Tray (f or 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
I Water Closet (Toilet) Other
(City)
(Zip Code)
(Address)
(Contact Person)
APPLICANT SIGNATURE
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 $
4/J1)
Building Pennit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOT AL PERMIT FEE $
3C(,50
.50
J(). (){)
I
(Office Use Only)
Building Official
Date
\.
paiW? Va / cP
Date II-:rb ~
)
Receipt NO'L/o9llR<//
By rr/
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
~ -:;>"'3-o?, Lf ~OO
ADDRESS I ~l ~ l
E\lG.II\."5toV\
OWNER
CONTR.
PHONE NO.
PERMIT NO.
c}f - 133 I
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~ FINAL
(r:i 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
~ W4\~ ~~-d"
COMMENTS:
Y\ee.~
r-
l4'lJ.h
~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
:::ECT ~:L FOR REINS::::::FORE COVERING
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOT'