HomeMy WebLinkAboutPlg Permit 02-0903
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
(Contact Person)
APPLICANT SIGNATURE ~~...-
/' V
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 orint and si2l1 at b~ ..~_)
ADDRESS
Ib~ 19 Du.bhn k~ S.e..
LEGAL DESCR..ll'nON (office use only)
LOT ~'BLOCK I ADDITION P ~ S~
OWNER 0 \
(Name) Son
(Address) l"~ 7<1
A A-\ \M\
I
bu.h\m I(J. s. E: .
APPLICANT l \ L\ -0\ \
(Name) l"-lOrO OWl T UM1\\)l~
(Address) 2905 6Jtuft.~J) AveMLU... ~
(Address)
Quantity
,
~. ~~ ~::y PERMIT NO.A~_aA~
3. Yellow Applicant (/ f7\ IV\..)
ZONING (office use)
,1</5D
PID ~5" 0 /'7- (/;),,/-0
(Phone)
(Cf5Z) '1'17 -'1&52
(Phone)
rVh\S
(Ci y)
(lD t Z) 827- tJ.o33
55Y09
(Zip Code)
(Phone)
DATE
7/15"/02.
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/(f'O .4
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
31 . S1)
.50
L/(J . 06
Paid L/o/-
Date "/ / d- 3 ..- d--
ReceiPV~Ss- <7---
BY~
9-1-~.~
1JaI~
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
"
i'
ADDRESS
/ (P (p 79
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION Q) 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION . 0 SEWER HOOKUP
I5l FINAL 0 PLUMBING FINAL
tf SITE INSPECT \ 0 MECH FINAL
COMMENTS: ~
DATE TIME
~z. -90'3
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
'" WORK SATISFACTORY, PROCEED
/ ~ CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
L': l. _
Inspector: ~~ Owner/Contr:
'/)
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETYI