HomeMy WebLinkAboutPlg Permit 02-0981
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File I PERMIT NO I ()
2. Gold City 0')- DO/
3. Yellow Applicant 0'- 7 I
(Please type or print and sign at bottom)
ADDRESS
:3037 LrJt::e H11V6N C-OUIC-I
ZONING (office use)
R{SD
LEGAL DESCRIPTION (office use only)
? I
LOT~ BLOCK .2 ADDITION A//JJCnINooO ()A-J:;.$' e..srn ::2lvd
PID /~2- 37/-0 ()g-()
OWNER
(Name)
~Nf}Geso;J,
LA Je,€A.f
,
(Phone) (,/2- (p 10- srn 2-
(Address)
APPLICANT
(Name)
s,qJVl&'
(Phone)
(Address)
(Address)
(City)
(Zip Code)
(Contact Person) ~" . ~ (\ ..... ,7 ~ (Phone)
APPLICANT SIGNATURE \-t.LfY'JL~ ~ \~\f1t;~ DATE
9- B-~o~
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 #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
39.50
.50
4(}.00
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid-#./..J. c;JU
<U'( '() r
Dateg" C, -()C).
R/,fl7~ '3
By ;;P
/AI
(J
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
3/)5.7
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
SCHEDULED 10 '?-l-(')~ _I::r
DATE TIME
1d1(k ~
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
'2 - ~P5(
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AI~
^ ( IIJlA.-ILJIA.
/
~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o COR ~ ~ORK, CALL FOR REINSPECTION BEFORE COVERING
I nspect,,1' , .----J
CA~L~-98 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
\
CODE
Owner/Contr:
UlREMENTS ARE FOR YOUR PERSONAL HEALTH .{ SAFETY!
lNSNOTl