HomeMy WebLinkAboutPlg Permit 05-0685
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
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ADDRESS
(P::)~A-R~~PfiC.-h n E
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
(Address)
APPLICANT _n,
(Name) -~V\ ~,h~. ~I ~ c
(Address) lr.; to ;z, (D .p e. vt V\ HU e.- .~ /"')
(Address) - -
(Contact Person) =1-~.J.:c::... I )e...~ 1 ~//
"PLICANTSIGNATURE .~ yW
Quantity
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
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Estimated Cost $ , or)
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
"'his Application Becomes Your Building Permit When Approved
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
7. 18. () 5
I. Blue File PERMIT NO
2. Gold City . OS 0 08S
3, Yellow Applicant
ZONING (office use)
PID
(Phone)
. (Phone) (at1-fr(p(n- /30" 7
R,e-h-Cefr,) ,~s4Q)~
(City) (Zip Code)
(Phone) f.pL'rl. ~-~~/
- (
DATE
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Building Permit #
~ 1'. . C:;(')
.50
~
paid~. 00
Date "7 t:J 5
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ReceiPt.~o. H8/~
BJf(JP
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
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, ,
./~d
ADDRESS
~~7>r ~~~~
OWNER
CONTR.
PHONE NO.
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PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
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.'iJ SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
I::l.~RHOOKUP
~PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
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~RKSATISFAC~PROCEED ~
/ ~ORRECT ACTION AND PR CEED
o CORRECT WORK CALL R REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
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