HomeMy WebLinkAboutPlg Permit 02-0122
CITY O~ PRIOR LAKE PLUMBING PERMIT
Date Rec'd
(Please type or print and siJ!n at bottom)
ADDRESS '5l~~6i W n ~- ~
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
t~ Delila v
(Address) Ql{?lfl ~() }~ S{1
~;;~~ANT . (;QrrllA mu JY
(Address) _li1uD Ui!JJJ.1t' ~I)
\.,... - - ,-.
rt (Address)
(Contact Person) l1 xxAtI
APPLICANT SIGNATURE ~1 .;
OWNER
(Name)
Wrv
DATE
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture I 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)
Quantity
1. Blue File
2. Gold City
3. Yellow Applicant
PERMIT NO"""... .,.,
lA:o'. - (:) l~
ZONING (office use)
PID
(Phone) ~- ']24... ~1V
(Phone) ~~'"'ll~IJ;1JO
WltUnliJ ~L/
(City) (Zip Code)'
(Phone) ltL~ ~
<J161lJl,-
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 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 #
$ ">1. ~o
$ .50
$ '10 . () 6
Paid
R~,~ ~o1
By lib l
Date:2 - 7 -OL
24 hour notice for all inspections (952) 447-9850, fax (952) 4474245
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
,-
ADDRESS
'5i39
OWNER
CONTR.
PHONE NO.
PERMIT NO.
0;).. - !;)-~
o FOOTING
o FOUNDATI@O
o FRAMING
o INSULA TIO
'tI:l FINAL
b 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: t-\t. 0 ~~
(1~ ~~
~::;g,'-
-v WORK SATISFACTORY, PROCEED
(0 CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: l3. ~ .. Owner/Contr:
CALL 447.9850 ~O~ THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
.~-
~..