HomeMy WebLinkAboutPlg Permit 01-1223
Date Rec'd
CITY Olf PRIOR LAKE PLUMBING PERMIT
I. Blue File
2. Gold City
3. Yellow Applicant
PERMIT NOO/_! ;;.;;-3 I
(Please type or print and si~ at bottom)
ADDRESS 17 t )
.30/~ 1v~//2-#4.J(~S.0
LEGAL DESCRIPTION (office use only)
LOT ALOCK ADDITIO~ L- S~ 4F33
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6slS'wL ~J ~S-'F_
~~~~ANT ~ 12._ J
(Address) ; C_7.Y~ 2-~-~ ~V
(Add~ss)' (City) (Zip Code)
~---~ /L ..' c,/) /f
(Contact Person) ~~ / /~~ ~ (PhoneJ-'1' / Cj - :;).1 "/.-e.
APPLICANTSIG:;URE ~4~ c?~~d-_ D~TE' -
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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)
OWNER
(Name)
(Address)
Quantity
ZONING (office use)
A/5J)
PIQ;?S..../Ob- 00/-0
(Phone) ~-:J:- VY)-(Y'$ /
,
......---?
(P~~?-- y~ --J// 9
" -/'"
Type of Fixture
I
,
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
(Office Use Only)
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
37 SO
.50
c/O, C/O
Building Official
Paid I/I/D /oP-
Date
/0184//
I /
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
Receip~ 1 ~ b
Byv
This Application Becomes Your Building Permit When Approved
Date
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
~w;U..o~ Q')3Q
35/B uJl'\l()~ ~~ .st. SW
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
0(- (z..-l.3
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS: ~~e.v-
~K SATISFACTORY, PROCEED
o CORREC C N AND PROCEED
K, CALL FOR REINSPECTION BEFORE COVERING
J
vYl
447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
Owner/Contr:
Inspect r:
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI