HomeMy WebLinkAboutPlg Permit 02-0697
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERlVul
,
,
\
I. Blue File
2. Gold City
3. Yellow Applicant
PERMIT NO~ - 69~
(Please type or print and si~ at b~..u~)
ADDRESS
/5700 n/ /(!fif:;L--L-
e / ~ (!.,t-8 S t:;,
ZONING (office use)
~/SD
LEGAL DESCRIPTION (office use only)
LOT/OBLOCK z.. ADDITION n/7t!rtC;L-L- PdA/.D
PID 25"-/55 - a/2-~
OWNER
(Name)
,
WAt,W ~ Jt;,A tV Sertr/Ot-&
/5700 .M/7t:I#6{.,l.- ~/~(!,,{,e
(Phone)
440-/4-52.
(Address)
s6
i P. v.
,
APPLICANT'~I.AJJ'J d L., J _ J I
(Name) w~ 1\. ~dll
(Address) jr.1tJl) JtiJi/~I,/ '4ft Sc
(Address)
(Contact Person) U1fj/l, ,e J /hr II / / /
APPLICANTSIGNATU~ ~#~
/v
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)
AlA IIhttf
. (City)
'1";0 -/VjZ
rr ~7"2--
(Zip Code)
(Phone)
DATE
1~AI d-y-
r
Quantity
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 $3950 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
$ 39.50
$ .50
$ 4-0.00
(Office Use Only)
Building Official
Paid l/. or) Receipt No.
6'f'() ( l/.J /7/
Date Date ~/ ~ -0;) By t;(j
24 hour notice for all inspectio~ 447-9~X (952) 447-4245 V
{I) F/#,qL /NfP&V70'</ ~&tJl/t!6..0
This Application Becomes Your Building Permit When Approved
ADDRESS
I 57tJtJ
DATE TIME
SCHEDULED l./rJ/trr..,. Jh.-T?
,
~ (J~.
CITY OF .pRIOR LAKE
It.lSPECTION NOTICE
. ,
PHONE NO.
CONTR.
PERMIT NO. 02. - (0 cp 7
OWNER
o FOOTING 0 PLUMBING RI 0 EXIGRADIFILLlNG
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
. FINAL 0 PLUMBING FINAL 0 GASLlNE AIR TST
:;;~;:~:~~ ME~
/J/l ,_
('!/~
't:JNORK SATISFACTORY, PROCEED
,{;' CORRECT ACTION AND PROCEED
o CORRECT W~R ALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CALL 447-9850 F R THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI