HomeMy WebLinkAboutPlg Permit 01-0166
CITY OF PRIOR LAKE
Ot
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1. Blue Fire
2. Gold City
3. YeUow AppJj,
Th. C.nler of Ih. Lake Counlry
Applicant: ~NY1 PER~~ 7
Address: :2;~ ;~~~
Signature: ,-. tC / ~
Legal Description: Lot -~lockA /! Sub
Site Address: h::.-/ ~.j' ~/l'r-/I_V
Building Permit # .PID #
NOTE: This permit will not be processed without complete information.
PP No. 01- 0 I'
Phone: ~ S-~ - ""/';> J'- ;. .
FIXTURE UNITS
Quantity
Type of Fixture
Quantity
Type of Fixture
Bath Tub with or without shower
Dishwasher
Floor Drain
I
Rough-ins
Water Heater
Water Softner
Stand Pipe (washing machine)
Sewage Ejector
Backflow Assembly (RPZ, Double Check, PVB)
Backflow Assembly Test
Lawn Sprinkler
Lavatory (bathroom sink)
Laundry Tray (1 or 2 compartment sink)
Shower Stall
Sinks
Bar Sink
Water Closet (toilet)
J 1""\................
FEE SCHEDULE
REQUEST FOR INSPECTION
SENT TO CONTRACTOR. NO
RESPONSE - CLOSE FILE
Industrial, Commercial & Multi-Family
(1 % of job cost, $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alterations
State Surcharge
$99.50
$39.50
$ :3 t:f.ro
$
$
$ .50
GRAND TOTAL
$ 4<J.tJO
This permit is granted upon the express condition that said
contractor, shall comply in all respects with the ordinances
of the State Plumbing co~mendments thereof.
.3 ~3 REC "3---Q-Of DATE
A TrEST
, .
Call for all insp tions 24 hours in advance.
16200 Eagle Creek Av. S.E. Prior Lake, MN 55372/ Ph (612) 447-9850/ FAX (612) 447-4245
An Equal Opportunity Employer
DATE TIME
..liCE
SCHEDULED
.:J/ 26 k 2-
, ,
~ &.d-
/tJ.' ?c
ADDRESS
/5/?5"
OWNER
CONTR.
PHONE NO.
PERMIT NO.
Of -I' tP
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
... FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS: ~O .M{~
~p~ r~~~r
tf50l.... 4~.... ~r70
,~ JM.t>~1,.' ~N~-a-2"S'...O;t
o WORK SATISFACTORY, PROCEED
o .rRECT ACTION AND PROCEED
/ CORRE;;:~;;: FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
CALL 447-9850 FOR' 'HE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &; SAFETYl
INSNOTI