HomeMy WebLinkAboutPlg Permit 02-0468
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
5-z-02-
ol-(4/Q
1. Blue File
2. Gold City
3. Yellow Applicant
I PERMIT NO. ~z.-~ !
(Please type or print and sism at bottom)
ADDRESS
34'03 Gf"l! /l/Wff/ t/e ~
. ZONING (office use)
~Z--
\
LEGAL DESeRi.t'uON (office use only)
LOT 7 BLoeK ~ ADDITION ~H /1/ /..It.. () f"' c;UT],.J
PID z.r - s-rz. - () 22 - c.'
OWNER
(Name)
(Address)
. (Phone)
APPLIeANT /111 ~ /1/1 I I - er 17/ ~
(Name) /YI{f)Ofl.e ~u l'l()()((E w',4(((l TRVrfI1. (Phone) 76rj--)'6/J-OI CIJ
(Address) /011fo :;l.Jjc,"fh It r/'f !If), .P/1J~cEftJ~
(Address) (City) (Zip eode)
(ContactPerson) --P1~fJ1()ot2E (Phone) 7' )-'?1'1 -;2r;2 I
APPLICANT SIGNATURE ~d;4 DATE S--;2 - Cl 2-
/ APP~ICA~T 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)
Quantity
Type of Fixture
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
PLUMBING PERMIT FEE
STATE SUReHARGE
TOTAL PERMIT FEE
Building Permit # () Z- ..-o4-(P f2
.:3 9. n:;
..50
#,p'f./
$
$
$
Estimated Cost $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
ftt:lUJ . ~ - ~ -7J ~
Building Official Date
paid4-0. au
Dat~ -7
:J - 2,-0 "
Receipt No. 7
BY.~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
. ~ ,'" SCHEDULED g =!o- ~ fl-
3l/oa-~W~
coQ r/ .-'
ADDRESS
OWNER
PHONE NO.
PERMIT NO.
;;,- q6?
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
o FINAL 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS: fho M1') -
V U
o EXlGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
/.- A r.. ~- -t. -),(:) ~
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRE~R', ~ALL FOR REINSPECTION BEFORE COVERING
Inspector: ~,,\ ~ Owner/Contr:
CALL 447-9850 FOR TH~ NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
lNS1iOTl