HomeMy WebLinkAboutPlg Permit 01-0118
Date Rec'd
CI1.'Y OF PRIOR LAKE PLUMBING PERMIT
2-ZfeJ-O/
(Please type or print and sij!;l1 at bottom)
, ADDRESS
33/0 6LVNWA-TEK. 7l&1/G
I. Blue File
2. Gold City
J, Yellow Applicant
PERMIT NO'O/_ 0/ /8
ZONING (office use)
!ezsD
LEGAL DESCRIPTION (office use only)
LOT cr BLOCK 2 ADDITION 6LVNtVrtlt::..-f!?.. 2 Nf)
I
PID 25-3'6 - O/2:Q.
OWNER
(Name)
O~N 7J!O,eN t3612ej
,
5AM~
(Phone)
(Address)
APPLICANT
(Name)
(Address)
DAN ~,V/ 136R-6
I
.srl 1'-16
(Address)
(Phone)
Cj S2... - 2-z..(, - 7-32.5
(City)
(Zip Code)
(Contact Person) J} . ;1
APPLICANTSIGNATUREAJ~ tv, y~
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
Floor Drain I 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
(Phone)
DATE
2-2J..i-OJ
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 # 01- all It:;
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
3Q.50
. .50
4-0 00
(Office Use Only)
This Applicathm Beco.mes Your:Building Permit When Approved
/ ,'I ,/ "
Building Official
Date
Paid +0.00
Date
2.. z(, -OJ
Receipt No. .:3f1o+IP
By fJ/(
I
t
l ..'
2-Z-"- 0/
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF P~IOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS 33/ 0 .d~
I
OWNER CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
rJ( FINAL 0 PLUMBING FINAL
k:r SITE INSPECTION 0 MECH FINAL
COMMENTS: H-11 0 ~h..v.-
v .
(" -'
"\-C e-
DATE TIME
ilzio/
9: ()()
01-1/ Y
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
J
~ORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORREC~K1C' tLL FOR REINSPECTlON BEFORE COVERING
Inspector: If) '- \ ,(1.)./(J/ Owner/Contr:
CALL 447-9850 FOR THE~EXT INSPECTION 24 HOURS IN ADVANCE.
, . , '
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI