HomeMy WebLinkAboutPlg Permit 01-1075
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
9-27-0/
1. Blue File
2 Gold City
J. Y _How Applicant
(Please tyoe or print and sign at bottom)
ADDRESS
/ r,8fp 5 P61266/eJ N6 C,.I/<..c/...;e :5 W
LEGAL DESCRIPTION (office use only)
LOT /3BLOcK 5 ADDITION IS:;- ADD'" TO WEb/6U1!!A( POAfQSPID 2S-30A- (,),2-1"'0
OWNER
(Name)
(Address)
APPLICANT
(Name)
(Address)
(Phone)
,
13tJNAl61?!. } rOM Z SUE;
IfdS(g5 P6/ZGGIG/Alb
(Address)
(Phone)
447-3050
~'-.
(City)
(Zip Code)
(Contact Person) (Phone)
APPLICANT SIGNATURE /~AA-4 ..--..-_DI'h~'~ .~
447 - 3050
DATE 9-27,01
Quantity
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)
Type of Fixture
'L
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 # (J / - / 0 75'
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
39.50
.50
40.0D
'1'~7.01
pai~. b 0
Date '1/z.- 7/0 (
Receipt No. 4-~ C.3 /
ByfJl
/
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
/tJ!J<;!tJ,
~ .
A.,..,
ADDRESS
/ ta 3'" 1rJ 'S
~~
CONTR.
~,
OWNER
PHONE NO.
PERMIT NO.
1)( -/f) 75"
o FOOTING
o FOUNDATION
o FRAMING @
o INSULATION
,b FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS: ~ T-r"' J ~
,.
(IJlh4-< ~tJ ~
~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
:S:::ECT WO;;;;L :OR REINS:::::n::'FORE COVERING
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOrJ