HomeMy WebLinkAboutPlg Permit 02-0727
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERl\tUl
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ADDRESI4~lt(g ((Ob~ ~d.
I. Blue File PERMIT NO :J1
2. Gold City . ~"'1_ "-7--,'
3. Venow Applicant V 0(' / CJI'-
ZONING (office use)
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LEGAL DESCRL.t'TlON (office use only)
LOT "BLOCK .#)ADDITION .K A./Jh ctIc) ~ ~,uJ
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(Address) ~
PID.;>S--3 ~<1-a:J-o
(Phone) q Od - ~ - \8"15
APPLICANT
(Name) F\ -n..vDV\. ~
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(Address)
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APPLICANT SIGNATURE ~ ~
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)
(Phone) ~ ~d -RQ \ ~ 6 dl,()
~Wl}\j\n l-\ 56~I"l-
(City) (Zip Code)
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DATE 5~~9-od.
(Phone)
(Address)
(Contact Person)
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 $
'40~
Building Permit #
Building Official
Date
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.50
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Paid ~ ~tJd
Date b ' If" () 0-
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PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
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
COMMENTS:
DATE TIME
Z.,72-7
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
A-J~TST
(~'OV\,
I. WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
:s=CT~. FOR REINS::::::FORE COVERING
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl