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Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
CL....' ~
rt::: l'-flA(r tot'l. L L. {)Z ~ 80 s
I. Blue File I PERMIT NO. ~ . .;\
i ~:~w ~~~licant '91- I ~ /II ~
ZONING (office use)
1</
/'-IJ-/ I
~'
LEGAL DESCRIPTION (office use only)
LOT ,6BLOCK ADDITION
z;A /fcl'ohJ u !} JjOU{Jtl)~ PID;;>S - 08t;- OOb ()
\ OWNER
(Name)
(Address)
,<;r-}; We t'Ch
(Phone)
.sr
(Phone) q S d- g 90 / ~ {. ~
55378'
Sa uedj <-
(City)
(Zip Code)
(Contact Person)
(Phone)
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher , Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
f Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
APPLICANT PLEASE COMPLETE BELOW
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 $
Building Permit #
.50
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
Receipt No.
Date
Date 7~ J-"3---Y
By
Building Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
Residential Bupding Permit Checklist
Basement Finish or Interior Alteration to Single Family Homes
BY:
Date:
Building Permit # JID: ;;;5:'-
Site Address /LIJ-/ / ?..Ax:J !l~4~
'1 41-aJ6 V Zoning:;; (
~
Legal: L
B
Subdivision:
Existing Structure: TIS or NO
CONFORivIS TO ZONING Y"ES NO
ORDIN.Al,{CE
YES NO
Is tills an expanslOn of w.1e exisnng footprint or Refe, to Plannmg X
building height?
Is me property located within me flood plain? Refer to Plan..Tling I K
Does me alteration inc;ude any additional kitchens? I Refer to PlannL.""1g I Y'
Does me proposed alteration include any outside Refer to Planning
entrances ome: man patio doors? X
Is the proposed use of the finished space or Refe: to Planning
alteration for anything otb.er tb.an a nonnal single X
family home (office, group borne, day care, etc.)?
THIS CHECKllST MUST BE COMPLETED A..L'fD Ii'!CL1JDED Ii'! THE BU1LDli'!G PERiYl1T FllE TO
~l-\li'!TAli'! .-\. RECORD OF THE REVIEW.
LY~::vC?L.l.. TC~-U.. TC:.-:CZ.DOC
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PRIOR LAKE DEPARTMENT OF
I 'BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS /L/.;t// F..u:JA~ ~~
NATURE OF WORK ...b. L
USE OF BUILDING 'SF
PERMIT NO. ld- 5(~S- DATEISSUED 7-3-00--
CONTRACTOR ~rr'f-. ..<t'u~oJJ PHONE f'1 {- ;;L;;..oz:::;-
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
~- 1 . ..
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUILDING
ELECTRICAL
~
HEATING
DO NOT
r; c.o. /.,..L
SIGNED
OCCUpy UNTIL ABOVE
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections have been approved. On buildings and _additions
where no service cabinet is available, card shall be placed near main entrance.
FOR ALL INSPECTIONS (952) 447-9850