HomeMy WebLinkAboutPlg Permit 02-0647
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
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ADDRESS L { 1
5"2.103 A\~01 nT, '--' I'
LEGAL DESCRu- 110N (ollke = only) \ - S1~
LOT -, BLOCK 4- ADDITION WErJ<)M /'tfJ AJ I ~
I. Blue File
2, Gold City
J, Yellow Applicant
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PERMITNO.62~ ",
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ZONING (office use)
PID 2C;-?7<O-037-o
OWNER
(Name)
(Phone)
/ '(Address)
Ir APPLICANT 1/ N';-
(I (Name) Afn n(r~ ~.
I '1 I Jd 6 ..1 ,J;) , Wt:.7t t.;
! (Address) ./
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\\ PLICANTSIGNA=~-~~
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(Phone)
75~- VV"?-09.:J,.2
C.-/ A/, /J.
(City)
(Phone) tA/urJ!'
DATE
(Zip Code)
~J;} . Y?/;F- /~6 7
t5' -? -dCXJd)..
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Quantity
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)
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
x
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 #
PLUMBING PERMIT FEE
STATE SURCHARGE
/"t TOTAL PERMIT FEE
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, Vour BUUd~'f; 1;'~PProVed
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$ 39.-<)0
$ .50
$ to... a,?
Paid "'..... ..--
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Date tJ3/0Z,
Receipt No.
4z./3$
By tUff...
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
DATE TIME
~c
SCHEDULED
{~3l~
OWNER
CONTR.
:::J?/ -I/JA' .I.-/tV-? J/4 (}f-
U
d-~i/'l
ADDRESS
J60?t,3
PHONE NO.
PERMIT NO.
COMMENTS:
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 r" 0 GASLlNE AIR TST
o MEC;R~
/
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
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/) IJ ,./J r
I i JtUv
L/
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSliOTl