HomeMy WebLinkAboutPlg Permit 02-0889
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
1~/q. 07/
(Please type or print and slm at bottom)
ADDRESS
/;9'10; (lard; nOv/
i: ~~ ~!~ PERMIT NO. ()2 "OIJ,aq
3. Yellow Applicant V V
R,-d80 +r-
ZONING (ofticeuse)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
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(Address)' (City) (Zip Code)
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fJOL/JOJ?/) DATE 7/17/ oJ
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. (Phone)
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(Address)
APPLICANT
(Name)
(Address)
(Contact Person)
APPLICA! T PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher I Water Heater
I Floor Drain I Water Softner
I Lavatory (Bathroom Sink) I Stand Pipe (Washing Machine)
I Laundry Tray (I or 2 compartment sink I Sewage Ejector
I Shower Stall I Backflow Assembly
I Sinks I Backflow Assembly Test
I Bar Sink I I Lawn Sprinkler
I Water Closet (Toilet) i Other
t
APPLICANT SIGNATURE
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 $39.50
(Office Use Only)
This APPlic",.v\ ~romes Your Building Permit When Approved
f/~_-- 1.::J!j ,,0 Z-
Building Official Date
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Pennit # 0 Z.. 0 P; ~9
39tSD
).50
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$
$
$
Estimated Cost $
Paid 4- o. 0 U
Dat~. /q. dl-
Receipt No. I
- ~Z5~
BYp
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
DATE
C;y~3
.5 9tff/- ~ 18r(4(
CONTR. ~
~~
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
TIME
o EXlGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
kuu?J :5-1)/~/Y
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"'-L.-/ \, _________
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: W Owner/Contr:
, I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl