HomeMy WebLinkAboutPlumbing 03-1180
DATE nilE
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 11'),47 -r/)
ADDRESS /G 1'-11- Was.r: If r1 ct-r; /:,-:,.,
OWNER CONTR.
PHONE NO. PERMIT NO. :?-/IJ'D
o FOOTING o PLUMBING RI o EXIGRADIFILLlNG
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL o GAS LINE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS: Co" ICI-
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o CORRECT ACTION AND PROCEED
o CORRECT 7~~'~ FOR REINSPECTION BEFORE COVERING
Inspector: f/ vy Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNon
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
tj. ~. ()./
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I. Blue File
2 Gold City
3_ Yellow Applicant
PERMIT NO. ~3 - I Ie ()
(Please type or print and sign at bottom)
ADDRESS
1~'4d.
CV~Kk &.le
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID 'Z!:". 2-99.001. ()
OWNER
(Name)
&r \ ()JI\ ~CN +
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(Phone) CfOd- dd-lD -&;;)90
(Address)
APPLICANT
(Name)
(Address)
t\~'U'\15
lo\4 ?,@
(Address)
~\S
~} <<he
f.\\rt-&~
(Phone) to \d . 80 \ - 6=)lob
~u-~c.h\ V\ffrv\- 662>60
(City) (Zip Code)
(Contact Person)
~APPLICANT SIGNATURE ~
(Phone)
~
Quantity
~
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APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
I Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
I Shower Stall
I Sinks
I Bar Sink
I Water Closet (Toilet)
DATE Cl-"Z..-D,
Type of Fixture
\
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backtlow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
Estimated Cost $
ItJO~
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
3Q, 50
.50
LiO, 00.
(Office Use Only)
_1 This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid 40. (j 0
Date9, E. 0.3
Receipt NJ. , ,,/
q.--527J
By if
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
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