HomeMy WebLinkAboutPlg Permit 01-1041
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
(l-zl-tJ/
LICANT /1 /
ame) ~'1 ~ /t~A ///,6"
. .. ci
Address) .:::lcP?~ /7 ~ 4Ve-'?~' L/o.,/'/
- (Address)
Contact Person) ./r,6/) #_. .. ;)~
PLICANT SIGNATURE ~Kt.V/-
V /
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture I Quantity I
Bath Tub with or without shower I I Rough-ins
I Dishwasher I I Water Heater
Floor Drain I I Water Softner
Lavatory (Bathroom Sink) i I Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 compartment sink I I Sewage Ejector
I Shower Stall I I Backflow Assembly
I Sinks i I Backflow Assembly Test
I Bar Sink I X I Lawn Sprinkler
I Water Closet (Toilet) I / I Other
(Please tvtl~ ~r print and sign at bottom)
ADDRESS
/543B
Fo /C...J\.ITff6 F?O
I LEGAL DESCRIPTION (office use only)
LOT
ADDITION I'1AVf!5.S 2NO
BLOCK
OWNER
(Name)
(Address)
Quantity
1. Blue File
2. Gold City
3 . Yellow Applicant
56
PID 25 - n 'If -() IS -0
(Phone)
(Phone) J'5d ~;Y35?:3b
k:~e~ S- ~tf 1-5
I(City) (Zip Code)
(Phone) Y;/) c:J- r~ ; 5~;$C
0;1' ft){/?J /'
I'
DATE
Type of Fixture
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 $
(Office Use Only)
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
--
1- 'v1~o I
Date
Building Permit #
3CJ.5V
.50
-4-fJ , () 0
Paid 4-0 . 0 ()
DateA
-, '1.4. 01
Receipt ~4tJ'd3
IBy f ·
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR-LAKE
INSPEc:TION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
[J FINAL
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED C;.- ;;2/-1 I ; ,~
/~ t.{ 3 fi pn{J/h
CONTR.
PERMIT NO.
/-/641
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~
o EXlGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~r') ht!J7/
u
17
(JJWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CAJ)- FOR REINSPECT/ON BEFORE COVERING
Inspector: ~ / Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl