HomeMy WebLinkAboutPlg Permit 02-0640
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1. Blue File
2. Gold City
3. ;Yellow Applicant
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I PERMIT NO.Oz. -04{)
Date Rec'd
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Of,
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CITY OF PRIOR LAKE PLliMJUNG PERMIT
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(Please tvoe or orint and sil!;l1 at bv."'~)
ADDRESS
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C~m ~.JO
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ZONING (office use)
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LEGAL DESCRIPTION (office use only) /J ~
cLOT 3LOCK3 ADDmON <;,..0 WJ;....rre ~ !!.-+
PID L> -231-'037-0
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OWN~R
(NamJ'
"t~ess)
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(Phone)
(,c?1" Z. (Phone) '75.2- L/l/~ 7e-t:: )..
C<.!"'c~LJ~c!.s..L AI.E P,,1b</' tot(' MAJ. ~~-?7")'"
(Address) (City) (Zip Code)
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\ (Contact Person) ,.., IJt'/u,' c' &~\ t: (Phone) 4"'i')~l/t/'LJ'- ~C;J2 (5"~h~ ~(I3c.1
\' 'APPLICANT~NATURE,r:~i~ DATE ~- 3. ,l~~
~// I APPLICANT PLEASE C;MPLETE BELOW
I Quantity Type of Fixture Quantity
"'j Bath Tub with or without shower
I Dishwasher
I Floor Drain
I Lavatory (Bathroom Sink)
I Laundry Tray (l or 2compartment sink
I Shower Stall
I Sinks
I Bar Sink
I . Water Closet (Toilet)
APPLICA~ \
(Name)VO()/ c!
(Address) ~ </-5
.'
,
Type of Fixture
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I.
I'
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
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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 $
TQTAL PERMIT FEE $
3Ft. ~o
.50
-40' a;>
Paid
Receipt No. 4z.1 zC
By /l/J k
ADDRESS
DATE TIME
SCHEDULED ~ JJf~ /1:;:
E6 l/;)/" ~~d .:s+.
CITY OY;PRIOR LAKE
t~SPECTlON NOTICE
.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
~-~Lfo
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
'b FINAL
5 SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
-160 ~-prKlv
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l'1WORK SATISFACTORY, PROCEED
r; CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~/( Owner/Contr:
CALL 447-:;50~R THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI