HomeMy WebLinkAboutPlg Permit 02-0500
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(Please type or print and silm at b . ~J.., ",)
ADDRESS
C] YlQO titwn nwcttmJ
LEGAL DESCRIPTION (office use only)
LOT BLOCK
ADDITION
1tlwna f) fJJuq~lOJTt
~LQO fu\t)y) WaclWJ
~;;~~ANT ~errt.e-n ~~Y
(Address) \ v14D /yV1fdfJJi Yan1/
~ddreSS )
(Contact Person) :7<lVC~ ~ /1 /
APPLICANT SIGNATURE ~~ D
OWNER
(Name)
(Address)
-- -.
t- -
"""'-- .
S-B-(j2-
L Blue File PERMIT NO
~ ~:~w ~~~licanl . () Z" () ~ IJ ()
wxv OJ b~
ZONING (office use)
PID
(Phone) q5~-441-l0~
tUXVlQ; %
(Phone)Cl VS~- Lf35'- o1l0
UL~t\A ~UJ -cJ~LJlfLf
(City) (Zip Code)
(Phone)
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
Sinl Backflow Assembly Test
Bar REQUEST FOR INSPECTION Lawn Sprinkler
Wa1 SENT TO CONTRACTOR. NO Other
RESPONSE - CLOSE FILE
H:DULE
Industrialt Commercia. ~. n'&u..~gU"UJ ..'v va J"" ""'~" .......,.u g ifTJJ.J"V u.n;:dmum
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Pennit # (}1- - ,9JV
$~'.51J
$
$
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Omcial
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
.50
~.
Paid iflJ . yO
Date
5"r6 ~OJ,-
Receip~oi,;() t I
By jHJ
-
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
,) ~ J ~
t-I-. !) <. '
~ ~~~
O~ -----,J
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
en wU..v
/ J.-u J:J Ik:Ld
:.- J I
DATE
$ -;)7-0- /1 ~csO
5 i(f.p/?- ?Zru~TJ1 ~~
(b.A..J.,N.
~:1....S'6b
SCHEDULED
CONTR.
PERMIT NO.
TIME
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
~CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
'",pectOr. r Owne,lContr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCF.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &.r ~
lNSNOTl ___________