HomeMy WebLinkAboutPlg Permit 02-1421
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
/0. Z f C)'V-
I, Blue File PERMIT NO
2 Gold City '02.- h /'71
3 Yellow Applicant / ~~
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
I L/ 1i 3
511 '" fA/ I- c/fL A.J W
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER II",
(Name) / V( ( DO",A-I D
(Phone)
(Address)
APPLICANTAA." .- -/1
(Name) /" otJruz <(;"" 110 t)(ZC tJlt TC' <- (Phone) 76 "3 - j r 7 - ). 5" )... (
(Address) J 0 '] J0 :2. ?CJ T( ;r-/E I/l. /.JCf/"dtJ C~ ? 7 (
(Address) (City) '(Zip Code)
(Contact Person) ()/j JI[- 1'1 ()d 121[ (Phone) 7 ~ 3 ..;) )f (> 0 I (.()"'
APPLICANT SIGNA~URE 1/f r;t" t/t,{} DATE /0 -).. \.l- 01-
~LICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity I Type of Fixture
Bath Tub with or without shower I Rough-ins
Dishwasher I Water Heater
Floor Drain .1_ Water Softner
Lavatory (Bathroom Sink) . Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall Backtlow Assembly
Sinks Backtlow 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 # () 2 - / t./Z-I
PLUMBING PERMIT FEE $ ':;t 9. _,7
STATE SURCHARGE $ . .50
TOTAL PERMIT FEE $ ?IV ,.VZ/
(Office Use Only)
This APp.l~t~ ~omes Your Building Permit When Approved
VI! J/1 I (). 1.. '-I () L-
Building Official Date
. Pai~ ~ J
-fa ~(( v
Date'
fO. 24-. "t..-.
. Receipt NoA., 2-eJ
-r 3;1 2-
BY~.
,-.J
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
o EXlGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
IN al-.- / sET --f/;)-
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEr. i\-ED
ADDRESS
14 qq '3 ~u.'1'lM 1+ C /Y
CONTR.
OWNER
PERMIT NO.
PHONE 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:
DATE
TillE
d}
I?'-J-r
)_/c'-L'
('~) 6SC
FL
'- (' { -t...-.
'I
~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~fO , CALL FOR RE, INSPECTION BEFORE COVERING
Ii' "0~
Inspector: I t l)l . Qwner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
1/fS/IOTI