HomeMy WebLinkAboutPlg Permit 02-0939
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
APPLICANTL p J
(Name). ~D"'\ 1) J O/] (~f-.
(Address) :20{- 1?-i:5 4",,-<. tV, I-Ioj?k;~ )
(Address) I
(Contact Person) jJ ~~ V l ) IJM / /I! (Phone)
APPLICANT SIGNATURE vi ~JA-~
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
(Please type or print and sign at :"u;';"_)
ADDRESS
2e~~ FOY euA/
LEGAL DESCRIPTION (office use only)
LOT 2" BLOCK "Z-ADDITION
77-f6 '111 (....O.s
OWNER
(N ame)
(Address)
Quantity
8-/"'() 2-
1. Blue File
2. Gold City
3. Y enow Applicant
I PERMIT NO. Oz,.. 093'l,
, "'I!t'"._
ZONING (office use)
P()50
PID Z"r oJ 2,'17 -(}o8 ..r;
(Phone)
(Phone)
?n <J"]J-r~? I-
5".r:J V7
(Zip Code)
(City)
{at)....
, ;).)..1 '-( jY,-/
,It I {J'L
\
DATE
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
Building Permit # 6 Z, () 907 '1
.:J 'I. J:V
.50
~O. 0 ()
Estimated Cost $
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
This APPIi"U~' Y :-r BuUding PenoU When App..ved
~ . ~'J,07
Building Official Date
$
$
$
paid~. tJV
Dat~.
~'I-()~
ReceiPJIt5'90
By If /
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
ADDRESS
d tf!/Lf'
DATE
SCHEDULED ;;... '-1-3
?-a)Cp~
TIME
CITY OF PRIOR LAKE
INSPECTION N07l'CE
.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
;;;_<-;39
o FOOTING
o FOUNDATION
o FRAMING
o INSULA nON
o FINAL
o SITE INSPECTION
o PLUMBING RI 0 EXIGRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLlNE AIR TST
o M,FINAL _ 0
,=-~/~
COMMENTS:
lS~
/JlU
~
~TISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
. Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSNOTl