HomeMy WebLinkAboutPlg Permit 01-0649
1. Blue File
2. Gold City
J. Y tHow Applicant
Date Rec'd f1
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CITY OF PRIOR LAKE PLUMBING PERMIT
(Please tvoe or Drint and sign at bottom)
ADDRESS
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"
ZONING (office use)
4
LEGAL DESCRIPTION (office use only)
LOT Z- BLOCK "Z.- ADDITION t::It/l)/f' ~ u..- +171
OWNER
(Name)
(Addr~
/'. 'I
(~ AtLfeJ1ed ~r\,tW1b/~~
(Address) L 2- ,OD ~~,^f tr"ct~{
. (Address)
(Contact Person) T OvY\ (~oc. ""
APPLICANT SIGNATURE ~~
- .
,
PID Z6' -3 t ?~. Q.Q--'C
(Phone)
(Phone) 952 4~9 -'1000
LA.r~Uill ( 55044
(City) (Zip Code)
(Phone) Cl2 ~(p1 -G,SO";1
DATE Co-Z9-l)(
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall ...Backflow Assembly
Sinks ./ Backflow Assembly Test
Bar Sink .,/' Lawn Sprinkler
. Water Closet (Toilet) 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 $
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
This ApftnttJ! ~ecomes Your Building Permit When Approved
j:'./-/~ ~ . z,9 r () (
, Building Official Date
Building Permit #
$ 39.S7J
$ ," ') .50
$ ;f-() IVV'
Paid ~. r/l}
Date a . z.. 9. () /
Receipt NO'2 ~7 /
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
INSPECTiON NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE ':"''-_
.~;
,_ ~DULED !-d).. 7 --Q3 .,+."'z,,,.
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~J\__I~'_ ~ ~
CONTR.
PERMIT NO.
!-{, 4CJ
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 A 0 GASLlNE AIR TST
o MECH FINAL A 0
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o WORK SATISFACTORY, PROCEED
~ORRECT ACTION AND PROCEED /
o CORRECT WORK. ' CALL FOR R~I~SPECT.ION B,E!:2~E COVERING
J -,' ',.. 'i '-{/7 b'Fi€blof
Inspector: ~~ Owner/Contr:
/' ,/ 1---
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI