HomeMy WebLinkAboutPlumbing Permit 03-1236
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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COMMENTS:
DATE TIME
,? '1
:.) -,iVO
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
~ #'~ Ai.li)ST
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./
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~ CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
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CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
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CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
r-.s. 0)
~ase type or print and silm at bottom)
ADDRESS
14/'-12 CedMwoool rOlut
LEGAL DESCRIPTION (offitt "" onlY).. 0 . A
LOTI!) BLOCK 3 ADDITION ~
I. Blue File
2. Gold City
3 Ye\low Applicant
PERMIT NO. 03-la~
ZONING (office use)
pM0 3rd
PIDr25- (J/L(- 03/1,'
(Contact Person) (Phone)
APPLICANT SIGNATURE ~~--.--- DATE
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)
(,,-f>_jf>H'1 J Od.N\
I '-II L/Z CuJ~wood CCI"UIfi-
~:;~~ANT f\Jo f \J\O'M ~t\MMb\^;1
(Address) 2'105" ~h ~ I cl Av@.. >5t 4> .
(Address)
OWNER
(Name)
(Address)
Quantity
(Phone)
('CSl.) L/~" -Ol7b
(Phone)
((" l2) 827 - ,-/0..?3
(;S'/og
(Zip Code)
w\'D\~
(City)
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Type of Fixture
I
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
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
:s,.. s-o
.50
4t) .. 60
Paid L/t).--
Date q-lb-.3
ReceiVS"3~
BY~
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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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