HomeMy WebLinkAboutPlg Permit 01-1325
Date Rec~
I. Blue File
2, Gold City
3, YeHow Applicant
ZONING (office use)
tid..-
CITY OF PRIOR LAKE PLUMBING PERMIT
. .
(Please type or print and sign at bottom)
ADDRESS 3-<; t5<S" /791t'1t! !4eJ?-r!t!JttJ &R.J/ e c5c::-
/!12J,t:' .rP _ M K-e /1111) .&j' ~~ '7 P-.
i11JIf&Q
~=e~R I!t-al-~ c5 r:.~4-j/;,~
(Address) /~ p- 5~n' ~LJ
APPLICANT fl J
(Name) (? tJ/d.JZ'j .me ':le~ (Phone) q.~..:z..-'r9 5'-.=? 7~/')
(Address) i-$ 7~!J /:'~e cUte ~ 4f<::, !/;~ ,flU! s=c.,-(1 ~-'/
(Address) (City) (Zip Coder
(Contact Person) ~~CJ~d'! ,~_p~ (Phone) q.s:~~- .3 7?~
APPLICANT SIGNATURE ~,k~Jd/!U ~~) DATE
./' Y'
APPLIC{NT PL ASE COMPLETE BELOW
Type of Fixture I Quantity
Bath Tub with or without shower I
Dishwasher I
Floor Drain I
Lavatory (Bathroom Sink) I
Laundry Tray (1 or 2 compartment sink I
Shower Stall I
Sinks I
Bar Sink
Water Closet (Toilet)
LEGAL DESCRIPTION (office use only)
LOT L/ BLOCK) ADDITION
,
PIrh5-37:a"'l)rJQj)
(Phone) ~ :?~q -.L//J~-/9"~
/nf?~~ a~tle ~r;:r 4J~.p4~
Quantity
Type of Fixture
'L
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
I Backflow Assembly
I Backflow Assembly Test
I Lawn Sprinkler
I 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 #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
-:z c;,!;" 0
.50
CIO.OO
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
paY/t!O LJO
Date //-dfO /
Receipt No/ () CfLj.3
By 4e/
u
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
5~~?
~-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDA nON
o FRAMING (@)
o INSULATION
"p FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS: ~
DATE TIME
)2/2-7~ jl?t1
-;
~
tJ( - / .f};)S
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
Jill WORK SATISFACTORY, PROCEED
10 CORRECT ACTION AND PROCEED
o CORRECT ~ALL 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 & SAFETY!