HomeMy WebLinkAboutPlg Permit 01-0755
Date Rec'd
ell i OF PRIOR LAKE PLUMBING PEAA.l.l.l
..
..
I. Blue File PERMIT NO
2. Gold City "LIlt, _ 0 -'. F'-LL
3. Yellow Applicant orl 0.::11
(Please tvDe or print and si2l1 at L ~~__)
ADDRESS
lL.fqqj. t?etVu} ~NC frt'(j~ LII-,KC
ZONING (office use)
LOT
LEGAL DESCR.J.r uON (office use only)
ADDITION
BLOCK
PID
OWNER 1" fV\, l(' . ~
(Name) ~. I/n 1 (t-:;Jj F f1
(Address) 14l./47 E!tuve.n Gt 11 ~ r ,) r L.aIcL
APPLICANT 1 "rn 56;/J rillf /\
(Name) C::Ik' tJ{ 'vr-v UL'f ,
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sa. rnl/
(Address) (City)
(Contact Person) ~rrt4 (Phone)
. APPLICANTSIGNA~~~~ DATE
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)
(Address)
Quantity
(Phone)
'1S-.:J 42--'1633
(Phone)
Qtn-t-
(Zip Code)
~me.-
1 W/OI
.
;
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
FEESL~DULE
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 $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.50
ing Permit When Approved
Paid ~iP/~?-'
Date I ~~..-D( By ()I)
j.--7t?J-- 2&eJ I
Date .
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
.'
ADDRESS
1L/~9 7
DATE TIME
SCHEDULED ~ It. r.
~ ~y-,
Cll2I" OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
t1/-/J~
I
o EXlGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
o FOOTING
o FOUNDATION (@)
o FRAMING
o INSULATION
~INAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
"WORK SATISFACTORY, PROCEED
/0 CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~
./
Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl