HomeMy WebLinkAboutPlg Permit 01-0497
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CITY OF PRIOR LAKE PLUMBING PERMIT
(Please type or print and sign at bottom)
ADDRESS
lu566
Httrloor P \ ttcu
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID ~-I"IZ- aal, cJ
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Httrmr- 'Plttlb
~~;~~ANT GtJrnrm ffiLL"<<
(Address) llP1lfO 111 r1 n f b1 Thi11
(Address)
(Contact Person) r~UV n
APPLICANT SIGNAT~RE ~ d -...
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APPLICANT PLEASE COMPLETE BELOW
Type of Fixture I Quantity
Bath Tub with or without shower I Rough-ins
I Dishwasher I Water Heater
I Floor Drain I \ I Water Softner
I Lavatory (Bathroom Sink) I I Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 compartment sink I I Sewage Ejector
I Shower Stall I" - . - 1 1 .
I Sinks I REQUEST FOR INSPECTION
I Bar Sink I SENT TO CONTRACTOR. NO
I Water Closet (Toilet) 1 RESPONSE - CLOSE FILE
OWNER
(Name)
~0ct
LP56'1Q
(Address)
Quantity
5,2,+
~. ~~~ ~!~ I PERMIT NO.01-o.l ~ 7 "\
J" Yellow Applicant ..,..-,
t .
ZONING (office use)
PU..r 0
(Phone) ~-qrolq
(Phone) Q0rh-t.pj;j-- fJ170
LaJl vt l (l; fnDlJJ
(p::~:)(Ql9J -C1/q- ~/7:;iP ~~
DATE
Type of Fixture
t
FEE SCh.r..v'-'LJ.&:.I
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 $
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only) r
i a i en Becomes Your Building Permit When Approved
5- z4-~d'
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
Building Permit #
39. 50
.50
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Pai~{). (fl)
Date C"" _ vr~ d ,
Re1lJei . ~ (, J ()
By
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DATE
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7 ,
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,(( LAKE
.IN NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDA~ION
o FRAMING
o INSULA TI N
lCFINAL
o SITE INS ECTION
COMMENTS: IJ, u
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A urc6
tI
P/~
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~,
TIME
~/- ~ 7
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
f CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector: ~ /. Owner/Contr:
CALL 447-~O FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
IN$NOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!