HomeMy WebLinkAboutPlg Permit 02-1105
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
r-u- "02-
I. Blue File PERMIT NO r::'
2~ ~ .~27~~
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
~J'J(J 8CJ(~7 ~{~( /./ LV.
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
(Address)
APPLICANT J (/l/f
(Name) 1l~'1 iJ v...-oQ..r1fli:f.
. V
(Address) ~t,.. /7 /if 4v~A-c- ,0/'~
(Address)
(Co.ntact Person) J...e:.c-'} / ~ ~ _
APPLICANT SIGNATURE ~ /~~~./Lj2--
PIDC~S-. ...3 iiZ- ()? 4- '()
(Phone)
(Phone) ~Q ?"f,j S63b"
//tf~,,~ <""~f7';1
, (cfty) ~ (Zip Code)
(Phone)
DATE
~fP/tI~ -2-
. .
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture I Quantity
Bath Tub with or without shower Rough-ins
Dishwasher I Water Heater
Floor Drain I Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (I or 2 compartment sink Sewage Ejector
Shower Stall / Backflow Assembly
Sinks ( Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
Residential, New One & Two-Family
Residential, Additions & Alterations
/, :> -j / tIt)
Building Permit # U v -
39 57)
, 0' .50
A-rl li
"T L/.
Quantity
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
Estimated Cost $
PLUMBING PERMIT FEE
STATE SURCHARGE
TOT AL PERMIT FEE
(Office lJse Only)
This APPIi?Ji~n~~fomes Your Building Permit When Approved
il111lJ- i~ ,~, . (j .?-
Building Official Date
Type of Fixture
$99.50
$39.50
$
$
$
Paid A '" 0 \
,(I. U
Datea I.
,~ <<' ' (.1 L--
Rec:fjJ1fl
Bd
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o !3ITE INSPECTION
DATE TIME
SCHEDULED y-/tJ ~
c]ffSo 8r;bCU-!
CONTR.
PERMIT NO.
~ - /I(j~
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
,.0
COMMENTS: L{.2UfJ1 t/VLu~
u
l6IMk ~~) t/Z~AP W'
\.../ ~
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector: ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNO T1