HomeMy WebLinkAboutPlg Permit 02-0940
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
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LEGAL DESCRIPTION (office use only)
LOT f" BLOCK ~ ADDITION
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OWNER
(Name)
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(Address)
APPLICANT <2 I j) j
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(Address) t 5 tL 1 I L/7q1- )/
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(Contact Person) V eJ'J
APPLICANT SIGNATURE
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8- /,02-
I. Blue File I PERMIT NO I
2. Gold City .aI7-oOA_O
3. Yellow Applicant G- 7~ .
ZONING (office use)
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(Phone)
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(Phone) 15;} "1'1)
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(City)
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(Phone)
1'4J-~S~?L-
(Zip Code)
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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 I 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
Estimated Cost $
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
ecomes Your Building Permit When Approved
a--J.;OL
Date
Residential, New One & Two-Family
Residential, Addit.tions ~tions
Building Permit # ./
$99.50
$39.50
$ 3150
$ .50
$~
pai4.-0.00
Date
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
DATE TIME
CITY OF PRIOR LAKE C
INSPECTlON NOTICE SCHEDULED t) - ~-~ d 30
ADDRESS /'7t2U 0~~LL- S~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
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o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
o PLUMBING RI 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GAS LINE AIR TST
o MECH FINAL 0
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~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
CALL 447-98~HE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ