HomeMy WebLinkAboutPlg Permit 02-0922
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)
(Please type or Print and sism at bottom)
ADDRESS
3/04-
7JU- .
/I'()'~
LEGAL DESCRLl'uON (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
(Address)
APPLICANT
(Name)
(Contact Person)
~( ~/'n"
-'
~ ;'Y\e
. (Address)
IDYY\. 1-10 c. L
~J4?
V
(JCL~ed;ted
L ') 700
J- \1'tptl~,
i;-u: I
(Address)
APPLICANT SIGNATURE
Quantity
7- z,-9- () 2.
I. Blue File PERMIT NO ·
2, Gold City '()' -()L::JZZ-
3, Yellow Applicant V 7,
ZONING {office use)
PIDZS-J!;Z-O 1"1-0
(Phone)
(Phone) (j'{?/~ 9 -l.fot:>C)
Lukic/fie "75'0'-1(/
(City) (Zip Code)
(Phone) r:rz) ? C, ;:> - c; so :3
DATE - '/h 9/0 z.
Type of Fixture
-
~
I
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 #
02,.., 0 tlz Z,
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERNOT FEE $
(Office Use Only)
Becomes Your Building Permit When Approved
1. ~"o'Z--
- Date
..341,50
.50
~4. 00
Pai~O, (/V
Date
'I. 'V1 /1 z...
Receipt ~.
~ Z. 157 t.--
By P
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIO.(t LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO,
o FOOTING
o FOUNDA T/ON
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED d ,- J-j - 03
3 !t)LP A~bL7a cY~
CONTR,
PERMIT NO.
;) --{j;?- r
o PLUMBING RI 0 EX/GRADIFILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLINE AIR TST
o MECH FINAL 0
4J~~
-- /
/
/I/~
( ~l
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECT/ON 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