HomeMy WebLinkAboutPlg Permit 02-0377
1. Blue File
2. Gold City
3. YeUow Applicant
Date Rec'd
4--/17/02-
317
PERMIT NO.OZ-- ~
CITY OF PRIOR LAKE PLUMBING PERMIT
(Please type or print and si2ll at bottom)
ADDRESS
15/ G L/
M,<~ ; tot,{ ~ (
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
(Address)
~:;~~ANT Ace l{~cl { 'ted
'2 -z 700
(Address)
T~ H-o cl
APPLICANT SIGNATURE ~ I~
,
(Address)
.1/lMt\ ~ ,'vl q
~ lI\ (3 J 1"Jrt.t: I
(Contact Person)
ZONING (ofliceuse)
leIS I
PID Z-'5"'" Z53 -004-- t)
(Phone)
(Phone) q52 <t~ 9- '-/;~ c)
4kf v; II f ~s- 0 '-j(J
(City) (Zip Code)
(Phone) ~I i)J(,] - 6.,0 ~
DATE Q/,'7Io?
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 $ Building Permit # () 'Z.- ,. 0 3 7 7
PLUMBING PERMIT FEE $ :3~. ~-V
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $ 'f(I/W
(Office Use Only)
This Application Becomes Your Building Permit When Approved
II f)1/}- If- ., I 7 -O-V-
BuilMng Official Date
Paicl.
A-O,dU
Da~
q-- -' 1'7 -- 0 'l.--
Receipt No. -1
4-( '70 ,
BY~
''i~
~ .r
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
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~~
~<9u VJ.-r.l
O~: 317
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
lSlC;c./
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH Rl
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
~
CjjjJ:-t'~AL\
t~~
DATE TillE
~~.~
o EXIGRADIFILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o ~TST
/'-L~~
1J1A-\ ~~~ ttJ; L.f=t7' ~
o WORK SATISFACTORY, PROCEED
., CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!