HomeMy WebLinkAboutPlg Permit 01-0646
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
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(Please type or print and sign at bottom)
ADDRESS
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
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(Address)
APPLICANT 0.'/711 ,( f)V) m n (" fi r/
(Name) (" ilL; I U V I II! LA"
(Address) ILQ-l~O uf?dah~j2. 7ct\h
(Address)
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(Contact Person)
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APPLICANT SIGNATURE
I. Blue File
2. Gold City
3 Yellow Applicant
ZONING (office use)
PID
(Phone) C1Sifl-/JJ.91{ 0- LlS'2G _
(Phone) qc.::;r;}) - L/.~S - --?Jl,O
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(City) (Zip Code)
(Phone) ~~ (c(7_-Cl (q - iJ 10
DATE
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity I Type of Fixture
Bath Tub with or without shower I Rough-ins
Dishwasher I Water Heater
I Floor Drain I Water Softner
I Lavatory (Bathroom Sink) I Stand Pipe (Washing Machine)
I Laundry Tray (1 or 2 compartment sink I Sewage Ejector
I Shower Stall I Backflow Assembly
I Sinks I Backflow Assembly Test
I Bar Sink I Lawn Sprinkler
I Water Closet (Toilet) I 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
es Your Building Permit When Approved
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Date \
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Building Permit # 6 ( , (j ~4-e:,
3tl~
.50
4-tJ .4V
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Paid ~ _ crv
Date
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Receipt No. J f'f} '1
I IF)
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
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1/581-P~./fJG
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
SCHEDULED
CONTR.
PERMIT NO.
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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 0 GASLlNE AIR TST
o MECH FINAL 0
f6 f)'cfx(;* ~ ~
('~ -.;:to
)4 WORK SATISFACTORY, PROCEED
r;; CORRECT ACTION AND PROCEED
o CORRECT WORK~OR REINSPECTION BEFORE COVERING
Inspector: [. ~ t Owner/Contr:
rJ
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl