HomeMy WebLinkAboutPlg Permit 02-0752
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
1. Blue File
2. Gold City
3. Yellow Applicant
(p. Z,/, () Z-
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PERMIT NO. at.. ---0752.
(Please type or print and silm at bu..u~)
ADDRESS
5~ZO /lnd~ WOOD OfZ.,IVb N6
ZONING (office use)
LEGAL DESCR.1.t'uON (office use only)
LOT 7 BLOCK I ADDITION /m ,4DOtJ. 77J N. .sHtJ!e6 OFtJC$
PID 25-34-0 -
OWNER
(Name)
verr
tA5N~
(Phone)
I (Address)
APPLICANT
(Name)
(Address)
Jt;:;l-r L-6Nr::
.s~ne
(Address)
(phone)
CIS Z. - '103- q S"IL
(City)
(Zip Code)
(Contact Person)
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)
j/~
(Phone)
APPLICANT SIGNATURE
DATE
tJ~Ioz.J 02-
-
,
Type of Fixture
x
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 $
Building Permit # D ~ ... 0 75 'Z-
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
39. 50
.50
40.0~
(Office Use Only)
omes Your Building Permit When Approved
--- lo"" 24,.01.--
pai~ . 0 c) Receip~o. 3 2-~
D&~ + By j~)r
(Q-z. '02- j..... .
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
Date
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
t}l~
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
-
DATE TIllE
SCHEDULED tJ./((LjIJ"?
b-~
CONTR.
~~?~
PERMIT NO.
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
A 0 GAfLINE AIR TST
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~ 11
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~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
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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