HomeMy WebLinkAboutPlg Permit 01-1304
CITY OF'PRIOR LAKE PLUMBING PERMIT
Date Rec'd
LEGAL DESCRIPTION (office use only)
LOT ISBLO~K d... ADDITION fJ M~R/~.sf-
OWNER ~JIl r^nt n r; arrv r./1PnlJ -
(Name) Vu,., \ ( '{/ U ~/V, I
(Address) ~~r I 'l1 ~t1d.11l 1?oa;f
APPLICANT fl" AI. ~ A-\f\ (VIA ~
(Name) l~ llLlLdALJ I I ~ J~tt'
(Address) I(t1LtO 1:f~ fittt1
(Address)
(Contact Person) ~.
flAM1v
U
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)
(Please type or print and sign at bottom)
ADDRESS I ! II fl ' J . If\ ~ ·
'1 1/ \ .": t LJAlA' ~9 nc
APPLICANT SIGNATURE
Quantity
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
Estimated Cost $
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
I. Blue File
2. Gold City
3. Yellow Applicant
I PERMIT NO~/_ /=j()'-j'
ZONING (office use)
PID;;(S'- cJSE'-OI?-(J
(Phone) ~-,r~V .
(Phone) ~ J.1% - ?[]JO
tlLrmU~ ~
(City) (Zip Code)
(Phone) ~ ft1BJ 4/t1, U{g
DATE {(;laJ.t; I
Type of Fixture
Rough-ins
Water Heater
Water Softner J
Stand Pipe (WasHing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Building Permit #
~q_sO
.50
LI 0100
$
$
$
Paid 1j LfO f{l)
Datil_ /tf-O)
ReCe!) o'l1 ;;)-1
By / (j-(/
(J
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDl" '=D
d/;M/a ~ /tJ: 30
ADDRESS
L//I~
c"
#.jJdb- ~ 7?e.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
CJI -13(J~
o FOOTING
o FOUNDATION
o FRAMING ffJ
o INSULATION .'
11 FINAL
o SITE INSPECTI
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
o
COMMENTS: 1,.'1 ~ ~
(!,e~ ~~
!!WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR!5:.LL FOR REINSPECTION BEFORE COVERING
Inspector: I Owner/Contr:
CALL 447-9850 FO THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETYl
INSNOTl