HomeMy WebLinkAboutPlg Permit 02-0754
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
" '2-5 -:. () 2.-
\
OWNER \ / I /
(Name) 13r(J ('tt? v~(d.r71a/1
(Address) JIR~ rsrh~ ~~ 12,,'n-z!
APPLICAl'jT ~
(Name) At'Lr~.JAfi. r (phone) ~/2-.901- s-zt;n
(Address)-13ox 7/2 C~<~en SS,5/7
(Address) (City) (Zip Code)
(Contact Person) ~ .& .I~~-::. (Phone)u,IZ-RC/I- ~")'Z~
APPLICANT SIGNATURE ~ ~ r - ~ ~\-- ---........ DATE .a/2~/o Z-
APPLICANT PLEA~OMPLETE 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 sign at bv~;"~)
ADDRESS
2L9.1) ~
f11/~ 1Iu.,,-I-
LEGAL DESCRu"nON (offic;"use only)
LOT
BLOCK
ADDITION
Quantity
I
I. Blue File PERMIT NO *
2. Gold City V2 .....0 n.
3. Vellow Applicant /_
ZONING (office use)
PID
(Phone) ~Z- 7!lR..12J2
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
I 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 # () 2.- - () 7 s ~
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ 3~ 5CJ
$ .50
$ ~_ t/V
(Office Use Only)
This AP~Becom.. Your BuUdmg Perm;' Whe. Approved
- &~~r-"d2-
Buildmg Official Date
paid4-0 . cJU
D~ ,,-
U~?~ -()?
Re~p~~ 2A
, By 1J1fJ-
/-
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
INSPECTION NOTICE
.....
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED (- 3r-03
-3rRs- ~Acc:L, ('''I R pf--
CONTR. .0
PERMIT NO. ;(_ -;~L/,
o PLUMBING RI 0 EXIGRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLINE AIR TST
DME7~L
,
, r?/__
(?)OJ
rRK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
gALL 447-9850 FOR THE NEXT INSPI;tJ:TION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl