HomeMy WebLinkAboutPlg Permit 02-0870
Date Rec'd
CITY OF PRIOR LAKE PLUMl}ING PERMIt
1. Blue File
2. Gold City
3. YeUow Applicant
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PERMIT NO<:?~_ 8 7~
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(Please type or print and si2ll at bottom)
ADDRESS
'~5l ;;) R05twocd Rd .
ZONING (office use)
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LEGAL DESCRL.t' nON (office use only)
LOT f/BLOCK .I ADDITION KAJO~ #i//
PIDV- .3/()- 00'1-0
OWNER
(Name)
tJe.cJ\~ n'\0JJl~
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(Phone)
q6d.~ ~33-13J.4
(Address)
APPLICANT
(Name)
(Address)
1\ - ClYO\"5
BO'i l' ~
(Address)
(Phone)
told - RO\ - 5J.l.oO
653,-=r
(Zip Code)
Quantity
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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)
c.~~e.YL
(City)
(Phone) ~
(Contact Person) t\~ , S
APPLICANT SIGNATURE ~ .
DATE /-,'S: -0"""7
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
X 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 $
Building Permit #
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ ~9~
$ .50
$ liD ~
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid (71 L('Cl,cB-- Receipt ~;).$ M
Date .A By /L
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
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CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
'1IlA/tB
.
Itf/-;/2- ~~ ~
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
SCHEDULED
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
-2-~~
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
1 0 GrLlNE AIR TST
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~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
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Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
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