HomeMy WebLinkAboutPlg Permit 01-0496
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
5"'Z+"'cJ /
(Please tvoe or orint and siWl at bottom)
ADDRESS
11J11~ SVvrJ((lY QArclfl
~. ~~~ ~jl~ PERMIT NO. QII -0 A/}/ A
3. Yellow Applicant 7 ~
.
ZONING (office use)
12.. z-- s 0
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID 25" ~z.3() -OOS~O
~=e~R I\rCJlie; A11clQr0tm
(Address) 11 '~1cr S~n rt\~ ~I (L[l;
APPLICANT (lOA A-v\ m 11{ /(J/" /71 /L 4""J..i'::;- 11-v'110
(Name) 11 rUW11 IllVwlA . (Phone) ~5.,,f1- 'fJ - '/ ,
(Address) lWW :J{ldJJ)f..., 1bfh LaJiVll(// f371t)LI-f
(Address) (City) (Zip Cbd~)
(Contact Person) C10rd I.f ~rn /} (phone) iQ19) - C/8.- 1-l1q ~)
APPLICANT SIGNATU~E ~..C-t I: DATE
- A';'PLICANT PL~~l~iiLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
(Phone)
qS~-440-~Q19
Quantity
Type of Fixture
I Floor Drain \ Water Softne
Lavatory (Bathroom Sink) Stand Pipe (
Laundry Tray (lor 2 compartment sink Sewage Eject
Shower Stall Backflow As
Sinks Backflow As
Bar Sink Lawn Sprinkl
I Water Closet (Toilet) Other
Rough-ins
I Water Heater
r
Washing Machine)
or
sembly
sembly Test
er
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 $
39.5V
.50
4-1'J fro
. n ~ecomes Your Building Permit When Approved
5".Z,4--.01
Building Official
Date
Paid 9tJ .. t/7J
Datf- J
~ .2J-'.()
R~l;ol,:? 0
BJv
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
17,;J.7S
~.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULA liON
~ FINAL
b SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~~
COMMENTS: /-It- ~
(1f~
~
F; f (/,
DATE TIME
3/20/D"l-- A.r-I
,
f o.-t
(j
~
~/- '19(,
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
)4 WORK SATISFACTORY, PROCEED
10 CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~. Owner/Contr:
CALL 447-9850 F~J T~E NEXT INSPECTION 24 HOURS IN ADVANCE.
lNSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!