HomeMy WebLinkAboutPlg Permit 02-0925
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PEAAl11
L Blue File I PERMIT NO ~
2. Gold City . /1] _ /? ... j
3. Vellow Applicant (/t?" 7 (
(Please type or orint and sian at bottom)
ADDRESS
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~;;~fANT NDrtJllJrY't PI1Lm12irla (phone) (wl7--) )S],1/t.f()3?J
(Address) -1lJD5 (;]111 ft"tW )(ye,. 60. m/pt~,- ~
(Address) (City) (Zip Code)
(Contact Person) s,j?R'f N (J(b l ()'Y)/"\- (Phone) tltv'I &
APPLICANT SIGNATURE ~ DATE 7/1.'0 107-
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)
S.t.
ZONING (office use)
Al
LEGAL DESCRil'uON (office use only)
LOT H BLOCKL! ADDITION
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OWNER
(Name)
(Phonelqfj'))JU~
(Address)
Quantity
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
I Sewage Ejector
I Backflow Assembly
I Backflow Assembly Test
I Lawn Sprinkler
I Other
FEE SCHEDULE
Industrial, Commercial & Multi-family I % 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 $
.50
LW~
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
.-
Paid '-10" CJU
Date 7- 30 - 0...
RectlJ-57~
By de./
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
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CITY OF PRIOR LAKE
INSPECTION NonCE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
D FOOTING
D FOUNDATION
[J FRAMING
D INSULATION
D FINAL
D SITE INSPECTION
D PLUMBING RI
D MECH RI
D WATER HOOKUP
D SEWER HOOKUP
D PLUMBING FINAL
D MECH FINAL
DATE TIME
;2.-q,l.~
D EXfGRADIFILLING
D COMPLAINT
D FIREPLACE RI
D FIREPLACE FINAL
D GASLlNE AIR TST
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COMMENTS:
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D WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
D CORRECT WORK, '/:/ FORrREI~SPECTION BEFORE COVERING
Inspector: (IY 0f - t1l:&ner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
IN8NOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
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