HomeMy WebLinkAboutPlg Permit 02-1031
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(Please type or print and sign at bottom)
ADDRESS
5/53 fI~p.e. street
I. Blue File PERMIT NO I
2. Gold City . () '} - ''O~, I
J Yellow Applicant ^ 14 -:- }
ZONING (office use)
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LEGAL DESCRIPTION (office use only)
,
LOT ;;"0 BLOCK ?..... ADDITION ~~
P trnc:l PID ~ 5 -/5 5'--()~?--p
(e:r5Z) '1'-17 - 5bltf
(Phone)
OWNER 12 F
(Name) I...:JOY l.e...s ; ('OJ{) K
(Address) 5/53 f/CIJk St.
APPLICANT.. t b\ l)
(N ame) I'-J.O r ClYY\ r \ WN\b\ "Q
(Address) 2'j~5 0JbAheJcI AVe'. 50.
(Address)
(Phone) C CR I Z. ) 8 Z 7 - "033
Mp\~ ~":) iIJ2
(City) (Zip Code)
(Contact Person)
(Phone)
APPLICANT SIGNATURE 0~~~
~-7P -~
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)
DATE
8/15;(;2
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 1% of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $ '1tJ?) u:P
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
3~, $1)
.50
~O.OO
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid 1 '-10 )01.)
Date f ")...y~
Receipt H02 /I b 1
By aL/
V
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
~
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE
TIME
~ /(;g-oJ--3ob
~. . r ...1- ~t(
,.5 Is3 ~ ~I 'D '2 J_ wtY
-_I -./1
OWNER . CONTR.d ~"al
PHONE NO. . PERMIT NO:-::'~ <Ui. ~J
o FOOTING 0 PLUMBING RI 0 EX/GRAD/FILL!
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
~ FINAL 0 PLUMBING FINAL _. 0 GASLlNE AIR TST
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SCHEDULED
ADDRESS
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t!IO~C r / t-- ~
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o WORK SATISFACTORY, PROCEED
')(CORRECT ACTION AND PROCEED
~ORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector: rp /) Owner/Contr:
CALL 447-98-;[ F~R THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI