HomeMy WebLinkAboutPlg Permit 01-1314
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
l/~ IfI -01
I. Blue File PERMIT NO I
Z, Gold City . 0/- /3/4-
J, Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS
5&30' ..15~rtf-..c..s I .
'56
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT 5BLOCK I ADDITION S7D~S /!::>,
PID Z5 - Z,Z9- ~o5-0
OWNER
(Name)
SASENA,ROBERT
5636 150TH STREET SOUTHEAST
PRIOR LAKE, MN 55372
(952) 447-3077
(Phone)
(Address)
APPLICANT
(Name)
NORBLOM PI.UMBING CO.
{6t2)~T~
(Phone)
(Address)
(City)
(Zip Code)
(Contact Person) (Phone)
APPLICANT SIGNATURE ~~ .~ DATE
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity I
Bath Tub with or without shower I Rough-ins
Dishwasher J I Water Heater
Floor Drain 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) /' I I Other
Ii/?/ol
Quantity
Type of Fixture
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 $ 7'tm ~
Building Permit # (j / - /3/4-
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
3Cf.SO
.50
qO . -6"0
(Office Use Only)
f I / Ill) -0 I
Date
Paid
4<J.OO
Date / 1__ 1 (p / cJ I
Receipt NOA1, I
(J. ~r3
B~
-
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
DATE
.J~f, 2,
1
-1-L. .
J-:YJ ~ ~f I
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
6&,3{;
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING @)
o INSULATION
FINAL
g SITE INSPEC ON
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS: H?(J ~
(
{IJ~ ~P~.
TIME
Id/d'lJ
fJ/-ISII
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~ WORK SATISFACTORY, PROCEED
( 0 CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ , Owner/Contr:
CALL 447-9850 F-::J THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl