HomeMy WebLinkAboutPlg Permit 02-0822
CITY OF PRIOR LAKE PLUMBING ~ERMIl
.., .
Date Rec'd
1. Blue File
2. Gold City
3, Yellow Applicant
I PERMITNOO;2_~~~
(Please tvtle or print and sign at t ~ ..u_l
. ADDRESS
\5)56 woed b\St,'h 'T'c ""Q( \..c.a...fu. ff\N SS3,.a.
LEGAL DESCR.1.r uON (office use only)
LOT~BLOCK }/ ADDITION2JJ~ ~
OWNER.~j,
(Name) })o...:'\I ~ C. UlJO \ ~~
(Address)
ZONING (office use)
f?1
PID~5~,~ ~~... lO'7-t.J
(Phone)l~} ~~... L\~
APPLIC~~ _ _, 10 \~
(Name)~ m~\<A\ tDl\\-(t'.\tlDrl\) ~C .' (Phone) 1;156t ~() -l.{Klp&'
(Address) I:J.LfOq CaK1tt.1 ~d. \\ ~((\.\V i ll.(,.. 6'$~1
(Addre~ (City) (Zip Code)
(Contact Person) '-john 'B~'Nu\do('f (Phone) (~\?..\~~a-t)~t{
DATE ['/llfolp
i I-
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)
APPLICANT SIGNATURE
Quantity
v
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 1% of job cost with a $39.50 minimum Residential, New One & Two-Family $99,50
Residential, Additions & Alterations $39,50
Estimated Cost $ '"2A , t5D
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
?ft. 50
,50
4/).00
PaiP7i l' / oJ
:z:rfO
Date 7... ~_ ()J-
Ret1~~.Sf )(
By 9f:--
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS IS)"" ~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE
TIllE
,4.':-
SCHEDULED :7-'~
~ .~ck.
CONTR.
PERMIT NO.
-2-82'"2
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE~Sl. A.
J1( L.a.",,,," ~
/
rRK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT'rr:' CALL FOR REINSPECTION BEFORE COVERING
Inspector: . ~ 'q Owner/Contr:
CALL rS50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSNOTl