HomeMy WebLinkAboutPlg Permit 02-0622
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
L Blue File
2. Gold City
3 . Yellow Applicant
5-30'O~
m q~ I'd--
I PERMIT NO.O
(Please type or print and SiW1 at bu..u~)
ADDRESS
J~2.Z0 Mcl'~ StrttJ ppo')" ~h., Mt\I 6S31z..
LEGAL DESCRlt'TlON (office use only)
t~T '-I BLOCK 'I ADDITION PYlo",. bk-t
PID 2S~OO/0'30-0
~'::e~R LIT" ot Pr'~r L20
.
(Address) 1(,1-0 0 ~/t. LrteL. Ave.. & I
APPLICANT "j), .1 '
(Name) Btr"m:!k r/1MvI1:Jln-..
iJ ' U
(Address) /3 (, /5 Pa,yk..wuoJ 'J)rJ'~
(Address)
(Contact Person) CJn~ ~Cj~
APPLICANT SIGNATURE ~ ~
""
(Phone) 1./i./1-'1<{()3
1ho',- I cb.:~) <'5 ~ 7,2-
(Phone) '1S2 '137-- O"3~
P,IArn<,~/& ~533"1
(City) (Zip Coae)
(Phone)
(p1Z- ~2 1'- 3/11
DATE
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher ! Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
. Water Closet (Toilet) 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 $ ;325. ~
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
39. S-O
.50
~() ...fA)
(Office Use Only)
This Ap~~n/recomes Your Building Permit When Approved
Jt//Jtr 5,30- Oc.-
, Building Official Date
Paid # .so
Date
S.3d,d"Z.-
17/)
ReceiPt.q
By /I~
-I;
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
,
/(,Ut> ~~
~
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:
A1-d
, I
Ilu.I--
DATE TIME
~-OJ
2...'~.L
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~~L FOR RE~NSPECTION BEFORE COVERING
Inspector: -I-1L! ' q -IV~ner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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