HomeMy WebLinkAboutPlumbing Permit 04-1184
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CITY OF PRIOR LAKE PLUMBING PERMIT
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Date Ree'd
/IR: 04--
.ease type or print and sign at bottom)
ADDRESS
385.5'
e"IUJ 55 SlaG t;;; I
~: ~~ ~:~ PERMIT NO.O~_ _ //EJ.4-'
3. Yellow Applicant '"r" ~ 11
ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT5BLOCK Z. ADDITION WeS77!tJ~Y PtJNOS
OWNER ~
(Name) \l'A(\~~--,lQh'~r-
..J
(Address) ~~~ B~~
(Contact Person) (Phone)
APPLICANTSIGNATU~~(Y)'_~. DATE 11
APPLICANT PLEASE COMPL~ 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)
APPLICANT
(Name)
(Address)
Quantity
CtJ:LltuAN VvArEA CONDITIONING
6030 CULLIGAN WAY
MINNETONKA, UN 55345
(Addf~) 933-7200
PIDZS. Z9S.01.3.d!
(q~)/ I r'\
(Phone) '-t Ll. /- LI J r:J L\
(Phone)
(City)
(Zip Code)
~-Oq
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 ~. 00
Building Permit # () tI ' / 184--
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PEAAu 1 FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
31. SO
.50
4-0.00
Paid A-.
,v, (f,)
Date
It Z l. .c) 4-
Receipt ~O.ffJ6/tR
B~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
DATE TIME
CITY OF PRIOR LAKE 1~/o~ 1
INSPECTION NOTICE SCHEDULED
Jrfss- C.~ -J/
ADDRESS
OWNER CONTR. .~
ONE NO. PERMIT NO. O,t ,II e ""
o FOOTING o PLUMBING RI o EXIGRADIFILLlNG
o FOUNPA TION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL ~LUMBING FINAL o GASLlNE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS: I ~ /l /
U/q~r . !V7-eV-
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/~ WORK SATISFACTORY. PROCEED i.
o CORRECT ACTION AND PROCEEp / l : " '.. j
o CORRECTr~'JK,r~'LL(FOR RemSPECTION BEFORE COVERING
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L. Inspector: r' / i- j <-1-- Owner/Contr:
.; .
j
;1
1
1
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
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CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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