HomeMy WebLinkAboutPlg Permit 01-0184
03/09/01 FRI 11:16 FAX 6124474245
CITY OF PRIOR LAKE
~001
Date Rec:'d
CITY OF PRIOR LAKE PLUMBINGPERMI 1
(please JYpe or orint HI Jim at L..," ow)
ADDRESS-
/lf2-79 J)OJ/f. r:~"(. N~ f.
j<""
1. eluo FII. I PE~ro' I
2. Ool~ City. ..' "6/- O(~4-
,. y~",w API'ILOIIlI' CI
'4.. ZONING comw \lie)
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f! ,Ie /
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LEGAL DBSCRII' nON (offic~ 11$1: only)
LOT /I BLOCK I ADDITION KNOB H/L--l-. STH
PID 25 "308 - olt.. ()
I
OWNER /}/J.
(Name) I f/(tlfiirf1l1^-'J,,(
IIoMM
(Phone)
(Address)
APPLICANT /j 7 ( J r
(Name) ! At 1;# doh' Wkr!il-
(Address) .Ho 10 6c'J'n/h- fit-
(Address)
I () ___
(Contact Person) . f(()tV (!lfltlV' /7 ~ ~
APPLICANT SI(~ -lATURE ~ I /1"-"'"
/
..
/ L we..
~~J)O~l..tJIWt.)(PhOne) 4,f/~7..Jlr-11tTo \
~~~~ M~mZr
(City) j (Zip Code)
(phone) /; J[~7.l ~ -17 or'"
DATE;J' --f---{) I
APPLICANT PLEASE C9MPLETE BELOW
Quantity Type of Fixture . I '_...' Quantity Type of Fixture
II. .th Tub with or without shower Rough-ins
d shwasher Water Heater
f'l )Of Drain ~ tf"Witer Softner .=:>.
L vatory (Bathroom Sink) . -S-tand Pipe (Washing Machine)
L undry Tray (lor 2 compartment sink Sewage Ejector
~il ower Stall . Backtlow Assembly
~li l.ks Backtlow Assembly Test
Ii iI' Sink Lawn Sprinkler
'i ater Closet (Toilet) Other
1- - ---
FEE SCHEDULE
Illdustrial, Comm4i' ;ial & Multi-family 1% of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
I . Residential, Additions & Alterations $39.50
'.'
Estimated Cost $
Building Permit #
Bllildl.. C: Iid.1
.~
Date
}t~
.50
rd,~
I Paid 40.00
I Date3 ....19,. 0/
Receipt NO~Oq /
BY~
/-
r-
PLUMBING PERMIT FEE $
STATE SURCHARGE ., 'N;\$
TOTAL PERMIT FEE $
(Office Use Only)
/ ~1'1)~~ti"~"iI~~~!;.~Uildi~g Permit When Approved
~. . ., ,.;"... "~_ - ---1 r
24 hour notice for an inspettioftl (952) ""-9850, fax (952) 447-4:245
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CITY OF PRIOR LAKE
INSPECTION NOTtcE
SCHEDULED
ADDRESS / L( r;) 7,.p (7)(j-t/e- cr.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~FINAL
,/[J SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS: t\~ 0 ~'
..~._'''.
CY~U
OA TE TIME
3{21 for AX>
0(- /tfLf
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
tvWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~ CALL FOR REINSPECTION BEFORE COVERING
Inspector: \. ~ _ Owner/Contr: .
/ .
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI
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