HomeMy WebLinkAboutPlg Permit 01-0916
Date Rec'd
~11 i OF PRIOR LAKE PLUMBING PERMIT
(PIeUl: ~ ot III'iIIc ad .Ip ar baaDa\
ADDRESS ~ C\ So \)0.., ~o\o...
~
~:::.;, I PERMIT NO. ('y. ,'_ "
) v..... ......1_1 { / j ,
!ZON
I 1Z2
LEGAL DESCRIPT10N (DIke \lie D8I1)
, LOT b BLOCK, J I--- ADDmON ~.~_ ~
Plo;)5- 06/- 0 90-{)
OWNER
(Name)
I (Address)
. (Phone)
. ~:~~ANT ':)~~ \'l\um'oi~ (Phone) qS'd--L\L\i-to 13L\
(Address) 4~Cc ~d.'\Q\\ (~J.,c..\Q.. S ~ Q, ie, lo..\<J2- ~7:) 3 72-
(Addrca) (City) (Zip Code)
(ContactPer.on) 3'Q...~~ ~o..r . (Phone) (0\'2 ~ '14/- 30cg~
APPLICANT SIGNATUU .~ ~ DATE ca ( '2.0 0 l
APPLICANTPLEASECO~LETEBELOW
Type or J'b:lure I Quantity I
Bath Tub with or without shower i Rough~ins
Oilhw..her ~ Water Heater
Floor Drain Water Softner
i La~.tory (Sathraom Sink) ...... ~ ~ " Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 ~ompu1ment sink rt\ fJ/" Sewage Ejector
I Shower Stall \~ ~ Baekflo\ll Assembly
I Sirlks I Backflow Assembly Tesi
I Bar Sink I Lawn Sprinkler
, WaNt Closet (Toilet) r Other--
Quantity
Type of Fixture
-1
I
j
".
FEE SCHEDULE
Industrial. Commercial a. Multi~rIl'llU)' .% of job l:DJt wilh a $39,'0 minil7lum
(Omer Ule 0111)')
Estimated Cost S
PLUMBING P
STATE SURe
TOTAL
Residential. New One cl Two-Farmly 599.50
Residential, Additions &. Alleration$ 539.50
s
s
s
,~9,5D
~O
t-fO rOQ
- Paid rt!Lj !J .
D.te~ c123-61
I I
: Rec~~6f-b
By ~~
Thil Appllcatton .co.. Yo..r ..U41.1 pe~li Whe. Appro"ed
81111d'", om.III'
D..
J. bur ....ee ter alllupecdo.. ('52) "7-9150, ra. (952) ~7"'2.5
'-'---
CITY OF PRIOR LAKE
INS~TION NOTICE
"!\ .
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
SCHEDULED
L/9sa
~
DATE TIME
~~Io.3 ,4. f,
OI-9/(P
o EXlGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
:::ECTWO~:OR RErNS:::::~:FORE COVEmNG
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
~ PLUMBING FINAL
o MECH FINAL
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CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI