HomeMy WebLinkAboutPlg Permit 02-0065
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CITY OJ: PRIOR LAKE PLUMBING PERl\'lll
Date Rec'd
1- / {O-O2-
(Please type or print and si2l1 at b_ ~~w ~)
ADDRESS
5loDS CedarwDOd
.
{ I au ~&
LEGAL DESCR..u-uON (office use only)
LOT BLOCK
ADDITION
OWNER
(Name)
tltJAiI
J
5LP05
Nt
(Address)
APPLICANT SIGNATURE
I. Blue File
2. Gold City
3. YeUow Applicant
PID
(Phone)
(q5~)4LJ5--7D37
(bl:;) orJl-l/03-3
mDIS 55L10r
(City) .
(Phone)
(Zip Code)
(Phone)
~
I LMD-;h
DATE
Quantity
Type of Fixture
,
Rough- ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
Industrial, Commercial & Multi-family I % of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $ L/-DD. QQ
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
BJ{~ I-!.~ 4l
~.fB.
.50
L-/-O - ~
Paid 40 . dV
Date { ('
-' "I "0 1.--
Receipt N04/ ((, I
BY~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
~ .c/-. t) '2.. 3~ err)
ADDRESS
5(;05 th-//~OOD 7lU---
OWNER
CONTR.
PHONE NO.
PERMIT NO.
~.;~".!Jj
DJl!!7. Ol-IO~Z-
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
o PLUMBING RI 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUw 0 FIREPLACE RI
o SEWER HOOKU 0 FIREPLACE FINAL
o PLUMBING FIN 0 GA~LINE AIR TST
o MECH FINAL X I1L tJ rl'17e-.
~~ 0 S'()Pr.
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C7~ ~ _ :#=- ()'Z,- (p5
t'~ ~:tL- DI - IOL/Z-
}6]WORK SATISFACTORY, PROCEED
( 0' CORRECT ACTION AND PROCEED
o CORRECT W , CALL FOR REINSPECTION BEFORE COVERING
Inspector:
~
Owner/Contr:
R THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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