HomeMy WebLinkAboutPlg Permit 01-0796
ell i OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
(Please tvDe or orint and si2ll at bottom)
ADDRESS
) (P( l;)..
~)"' ,JAbr
\
lrJ
LEGAL DESCRit' nON (office use only)
L Blue File
2, Gold City
3, Yenow Applicant
LOT BLOCK ADDITION PID,25- 338 -OI~-O
OWNER ~VV\ ~t"OO\\, (Phone),QS 'f~ aG/)1
(Name)
(Address) 1f.,61~ ~t ,.J...,r l...N PrlCA LAt~ yY>>J . n-, ').l
~A )"t:-4r f J~ ~ LL('
(; CS ~ 1 J tl-rtl rp!1; Q-
.AAddress)
(Contact Person) F)'"'<. (" (V~'t-,
APPLICANT SIGNATURE ~~ ~
p v
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)
APPLICANT
(Name)
(Address)
Quantity
(phone) -.!lS;1. 'LJr::J
W. t'r~ L,J( \. .
- (City)'
(Phone)
frJ~
~ ~./.J.-
(Zip Code)
t J J- j (c. l/73 I
DATE ~t .:r~~)
,/
Type of Fixture
~
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly r /I {j
Backflow Assembly Tes~
Lawn Sprinkler J
Other
p'
I
FEES\..ttJ!.DULE
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
(Office Use Only)
Estimated Cost $
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
Building Permit #
.3f. >t)
.50
4-f) ,t/V
This Application Becomes Your Building Permit When Approved
!lIl14-- ~ V.I" d I
; Building Official - Date
Paid 4-0 . ()1)
Date
-]. 1A.t -17
I -
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
Recei71l~~ / 9~
B~
-
ADDRESS
1~~'7z--
DATE TIME
SCHEDULED ~ A..Tf
u5~ rL
CITY OF PRIOR LAKE
INSPECTION"NOTICE
.\
OWNER
CONTR.
PHONE NO.
PERMIT NO.
FJ/ - ""}q (0
o FOOTING
o FOUNDATION
o FRAMING (fJ
o INSULATION
INAL
~ITE INSPECTI
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS: 1t-tJ) ~ ,r. ~
C(!d~,~~!E~~
;'"
~RK SATISFACTORY, PROCEED
~"~'~RRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Insped"': ~) Owne,,,,,,,,,"
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTI