HomeMy WebLinkAboutPlg Permit 01-0660
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
~
~ a- DATE
APPLICANT :l':ASE 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)
(Please type or print and sign at bottom)
ADDRESS
/ '-/Ljr;9 1141a;~
LEGAL DESCRIPTION (office use only)
LOT ~ BLOCK3 ADDITION /I J....J:Yb IJ/ / /
OWNER
(Name)
(Address)
~~~;~~ANTPlp~LlYJrkS ~lJc-
(Address) f:,RO - (Ja/ JJa-UCL./ ~
" (Address)
(Contact personlR A. i ~
APPLICANT SIGNATURE
Quantity
~. ~~ ~~~ I PERMIT NO.,,/_ /\ / I J?\
3. Yellow Applicaot V U Go ~Q.J
~
ZONING (office use)
Rt
,
JIM
PI~J -36;;" tJdP'- 0
(Phone)
(Phone)
~,
(City)
It :3-'-1/3 -IP<;'3
,SS-~ / I
(Zip Code)
(Phone)
]- 3-01
Type of Fixture
J
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
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
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
39, S-lJ
.50
UI> .00
Paid 'if () t' atJ
Date 1- 3-of
Recei~N2;fl1 C:,
BY~/
U -
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
7-9.0/
/}3b
ADDRESS
/~7i )./IG'f17JJ~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
{)f'6~roO
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL tI2J 0 GASLlNE AIR TST
o MECH FINAL '!../:::I:z...P v''''''
?f'~
COMMENTS:
/'" ~.-
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'If WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ I Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTI