HomeMy WebLinkAboutPlg Permit 02-0264
Date Rec'd
CITY OF..fRIOR LAKE PLUMBING PERMIT
~. ~~ ~:~ PERMIT NO.",-o 'I J I V
3. Yellow Applicant Ud-- ;.JO )1
(Please type or orint and si2l1 at bv.....~)
ADDRESS
3'171) Sycant'~
TrA,'/
.
ZONING (office use)
"R I SJ)
LEGAL DE~R1.t' uON (office use only)
LOT1~ioCK ADDITION ~d
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PIDX-()qJ-()Ob~
OWNER
(Name)
(Address)
~, /ttde.r
3117/) Jy (j( JI1..IY't
(Phone)
f!".J - J~ /., - /d. '1
frA,'!
. APPLICANT rJ J J /' / /
(Name) nUh~ LIIPASA.-//XA-h
(Address) I/f~ J/~ /'t"A
(Address)
j, c.~ ~""I"I
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APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity I
Bath Tub with or without shower Rough-ins
Dishwasher I Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
(Contact Person)
(Phone) 9r.J. - 7r, - Y~..J >
~A//r~qlJ S~t:J71
(City) t/ (Zip Code)
(Phone) f'))-lfc- ~yy'
DATE 3,h'ft.J
APPLICANT SIGNATURE
Quantity
Type of Fixture
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 #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
1f~
,50
'ltJe!l.
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
paid# ~6' /::x)
Date (3 /o-7;();;-'
RelJ)~d1
BYgc
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
DATE TIME
ADDRESS
3'-1 '7 b
SCHEDUl~D 3 -;2d,.-Qd...
$LJcumove ,)-
,
CITY OF PRIOR LAKE
~SPEC'fiON NOTICE
OWNER
CONTR,
PHONE NO.
PERMIT NO.
n~ - Q?-lo l.)
COMMENTS:
o PLUMBING RI 0 EXlGRADlFllllNG
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GAS liNE AIR TST
o MECH FINAL 0
W~ ik~ :J-~
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
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----
~
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o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ / Owner/Contr:
CAll447-~-:;OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
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