HomeMy WebLinkAboutPlg Permit 02-0642
~~
C.. i OF PRIOR LAKE PLUMBING PERMI.
Date Ree'd
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)
(Please tvDe or orint and sism at b....__l
ADDRESS
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CI'r-~ Ie
~ CJ. '11er }.J"lA""""
LEGAL DESCRu- nON (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
(Address)
T<:,,~~
IYl Ad So N
APPLICANT
(Name)
(Address)
(Address)
(Contact Person) .......,
APPLICANT SIGNATUrob4
,
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Quantity
I. Blue File
2. Gold City
3. Yellow AppliCllJ\t
c ,fv4a-
PERMIT NOOJ~ O~
ZONING (ofticeuse)
lVtU
pa l .
Pill
(Phone) '+'17 - g I &"'(,
(phone)
(City)
(Zip Code)
J J
~/3/1J.:>
/ '
(Phone)
DATE
Type of Fixture
.L
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 #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
?'i. ~o
.50
'lO.D(/
Paid
Receipt No.
Date
By
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
.... DATE TIME
CITY OF PRIOR LAKE q-/7 jI.' 10
INSPECTION NOTICE " SCHEDULED
']'1 S-S evtft/ J1 ill J' ];
ADDRESS
OWNER CONTR.
PHONE NO. PERMIT NO. ~ 02-Ct42
o FOOTING o PLUMBING RI o EXlGRADIFILLING
o FOUNDATION . MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL o GASLINE AIR TST
o SITE INSPECTION fi!i MECH FINAL 0
COMMENTS:
,.
'07
~J">f'." #,
r'l
rfI-c:::...
~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~f q -/7' 02-.. Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE._
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
."