HomeMy WebLinkAboutPlg Permit 01-0726
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
5' ~').f/
, .
I. Blue File I PERMIT NO~V_
2. Gold City
3 . Yellow Applicant
(Please type or Drint and sim at b,u..u~)
- ADDRESS
\ L\ Ll S l \)e--o-e ~ r-T !\J i=- ' l Pr. e-f' WL e
LEGAL DESCRIPTION (office use only)
LOT I BLOCK 3 ADDITION~u.b
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PID.Q( '-3faK-O ~;;r,:;>
OWNER r (-\
(Name) ----J~ ~ \ \e:r~~ , (Phone)
(Address) t 4 LfS"I DEKT€- ~ t p~, o-r- L~L.e
APPLICANT (\
(Name) Je..ff ~Ol\ek~
0~e)
(Address) (City)
(Contact Person) (jo....AAA e. '\ __ .... (Phone)
APPLICANT SIGNATURE ' {df :st..u.t (,. .-J DATE
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
I Floor Drain
I Lavatory (Bathroom Sink)
I Laundry Tray (lor 2 compartment sink
I Shower Stall
I Sinks
I Bar Sink
I Water Closet (Toilet)
(Address)
Quantity
C}sz......"t q b -0' 2. Z.
(Phone)
~5~""4qb-e;,~
(Zip Code)
7 - It --0 I
Type of Fixture
I
Rough-ins
Water Heater
Water Softner
I Stand Pipe (Washing Machine)
I Sewage Ejeptor
I Backflow Assembly
I Backflow As~embly Test
I Lawn Sprink~er
I Other
FEESl,;t:lJ!,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 $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
3q. S-O
.50
<<-to , CJ ( )
This Application Becomes Your Building Permit When Approved
Building Official
Paid UfJ,oD
Date 011"7101
I I
24 hour notice for all inspections (952) 447-9850, fax (952) 4474245
Receylrl.3 Y)
B>[U ,
~
Date
DATE TIME
CITY OF PRIOR LAKE
INSPECTIQN NOTICE
SCHEDULED
I-n-co
DoOc .C!:::/-
ADDRESS
/l/tf5/
OWNER
CONTR.
PHONE NO.
PERMIT NO.
I <- 7~
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
o PLUMBING RI 0 EXIGRADIFILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLINE AIR TST
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,
X",,~~VStAL~ d\\/p~<
('~, lA)/lr.eV ~n l..s
o )'VORK SATISFACTORY, PROCEED
V CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REI~Sr.ECTION BEFOR~ )OVERING
~ A..r\ '1't7..QSS't
Inspector: ~ Owner/Contr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &; SAFETY!
INSNOTl