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Plumbing Permit 04-0202
'i., > \, , " ,-:i~t~!kJiJijJi~~~~l3fi;!, ,.... ..\ ......... . . . ...',1 .. .."'... ..'. at..e.~R.. ee.. ~d. ........ '.. .. . . .. . . .. ....,.,. \ .'I';~;,'l~."'.I.',......t...... .'CJ'.l.y.,QF fRIORLAKE PLUMBING PERl\'l.l.l~':'~~;~~:~I~;r;~.:i4 ~~t~~l~i~~h..; , , ' , . ~ ,'. ":~,f~t~~~~::~ ,~i~~Fil A8/N~~. ta s- p; itl . ~ " .. , :i.fEG~~BSCRIPTION (oftlce ~ only) .'~O~\f~LOCK 5 ADDITION -!\~O b #/1/ 0;/ci "' ; .' ," " . ;' ( ~:'.1'. , '. .. PID~,'- 339-()3d:'Q OWNBR;.~l~';t;::~:.. . .(N ,.. )...,.\:.;..-:.,::APIAIJ ,A/(),(p'o(... /J..J 6 ame I.... "'. OJ . . . . :11- .... . (AddreSs), ; ~A/l'f e ,.. . '"." '. (phone) 9 s:J - P?S" - '1 S-.J{; .... . :-..:~:~.; r:.~/j;~i~i: ~.:' :~~1. APPUCANT (Name)...... ~IfK.e c!i'oe, ~1,.(.)1&(8.1~' i . (AddresS} /~yt7 Z/NlfNA.) AJ/~ (Add. ...H)' \ . f~onta~Person) ~Jt>L I -"PLI~i~IGNATURE ~ ~ .(phone) --!l5oJ - i/fY- 76,00 . d,fV.,fa- t.S:.~3 7t" (City) (Zip Code) . (phone) 9&;- Jl9Y-7'oO DATE - Quantity . APPLICANT PLEASE COMPLETE BELOW Type of Fixture Quantity Bath Tub with or without shower Dishwasher I Floor Drain Lavatory (Bathroom Sink) Laundry Tray (lor 2 compartment sink , Shower Stall Sinks Bar Sink ..,:Water Closet (Toilet) Type of Fixture ,..,..... , Rough- inSc Water Heater Water Softner I Stand Pipe (Washing Machine) I Sewage Ejector I Backflow Assembly I Backflow Assembly Test- .1 Lawn Sprinkler.. .,:...:".,,~~;.,..........,;...;'::'';~;.:,'';.i;;..';. ..- .;....,;:<f 'I.Other. . > ":;.,l.":"...;,,;.:.i."~;~."'i''':.k.~...~,:;'J:,~'i,~~'.';' ..'. . ...' . ..:. . 1," I I , ; :..~.: ,.: '.;!. ,.... ....; ,.; .. :..: ... :.i:.:...,~!, i..,.~.,. ..." . . ., / FEESC~DULE . 1ndustJ:i,al; Co.mmercial & Multi-family 1% of job cost with a $39.$0 minimum Residential, New'One &. Two-Family $99.S0 :,1: i:' '.. Residential, Additions &. Alterations $39.50 r--'. (Omc~ U~~~y) . This Appl.icatioD Becomes Your Buildlu& Permit When Approved Paid </0 _ - -- ReCe!;t~.t/ L/ ( . Oat. DatCL::>. - 31 - /J~ B~Y. . .'J ~uUdllll omdal .. ;/-/ .... 24 hour DOtlce for aU1IIIpectlo~('5.2)'447.9850, fax (952) 447-4245 16200 Ea&l.Cn.kAv~ S.E., Prior Lake, MN 55372-1714 PLUMBING PERMIT FEE $ STATE SURCHARGE $ TOTALP~u~FEE $ cn.,ro .50 c;t' O. fII4D ~otJ) Estimated Cost $ Building Pennit # \ :\ \:\ \', \. DATE TIME CITY OF PRIOR LAKE LI-tLo'{ INSPECTION NonCE SCHEDULED ADDRESS /L,I1,. ?fr &J, 1J\ flJ OWNER CONTR. PHONE NO. PERMIT NO. Lf-J-oi- o FOOTING o FOUNDATION o FRAMING o INSULATION o FINAL o SITE INSPECTION o PLUMBING RI 0 EXIGRADIFILLlNG D MECH RI D COMPLAINT o WATER HOOKUP D FIREPLACE RI o SEWER HOOKUP D FIREPLACE FINAL D PLUMBING FINAL 0 GASLlNE AIR TST o MECH FINAL D ?ttW.-1 ~//'I..,!tI~/ COMMENTS: ~ ~ /' I ,r- / ) ( /./ tY'/ .n f.c; \V'v--^ , '" / '--- ---- ,,"WORK SATISFACTORY. PROCEED o CORRECT ACTION AND PROCEED o CORRECT "~FOR REINSPECTION BEFORE COVERING Inspector: "p Owner/Contr: CALL "7-98~Q FOR THE NEXT IN~PECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/ INSNOTl