HomeMy WebLinkAboutPlg Permit 02-0345
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
(Please type or print and si2ll at bottom)
ADDRESS
/6039 $/I-/c.///cll<- )2D
LEGAL DESCRIPTION (office use OnlY). j')
LOT R BLOCK ADDITION9'\' () J}JJ 5
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OWNER
(Name)
(Address)
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PALey
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M~;t., I J'e-It
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APPLICANT
(Name) __7)0/ j) M't!c.J1A-/t.// CAt. :r~C-
(Address) 9't:J~ y M/ #~V /t:1/ .Il/.c.,h T- B
(Addrefs) . .
(Contact Person) YE/t.-'~VJ /7
APPLICANT SIGNATURE ~ n~
Quantity
2-'
I
. .
I. Blue File I PERMIT NO ~
2. Gold City . /) 1_1),. "
J. Yellow Applicant Vt?I
ZONING (office use)
12/ S D
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PID::l5-~/- (JOg-q
(Phone) ~/Z - :3f"~'--//OQ
(Phone) 9s-z - %90- 9"z-~
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(City) - (Zip Code)
(Phone)
DATEh~,'L //-0 z.....
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APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain N
L t (B th REQUEST FOR INSPECTlO
ava ory a WNER NO
Laundry Tray ( SENT TO HOMEO .
Shower Stall RESPONSE - CLOSE FILE
Sinks 4/2003
Bar Sink
Water Closet (Toilet)
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
Estimated Cost $
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
Building Permit #
39. >-0
.50
410 00
Paid .,j;,. 0 ()
'lVt/tJ ~
Date .
Lj- J I-Do.-
Receipt No.
II /'0 7C;
By r;;L/
U
CITY OF PRIOR LAKE
INSp'ECTIO~ NOTICE
..
ADDRESS
150 3~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION ~
o FRAMING
~INSULA TION
'0 FINAL
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED ~?... ~"tI
~~.
CONTR.
~ ~,1
p~ · '(2, (,
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o FIREPLACE FINAL
o GASLlNE AIR TST
o
- -
~+o ~
~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: Ji ' Owner/Contr:
... r
CALL 447-9850 FO THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETYl
INSNOTJ