HomeMy WebLinkAboutPlumbing Permit 03-0929
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
"1./I.oJ
[. Blue File I PERMIT NO I
2 Gold City . ()? _ 0 r/7 i')
3. Yellow Applicant ~ -, ""7
,_ lease ~ arprint andsi2Il at bottom)
ADDRESS
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ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PIDZ-C 179.0() 7. /)
OWNER
(Name)~nD
t<o6/1t/'Son \
(Phone) "JS"Z - 'f t.f'1 - ~ ~/ .
(Address) 5~-
APPLICANT ~ A.
(Name) nt'....... f!)... rLtlllAf"f/l<1
. J .
(Address) (PI" rt.JA.d ~ 5. (,,(/,
(Address)
(Contact Person) j)~III(S <<7f~ . ,/ ~
APPLICANT SIGNATURE v.- Lt,?' r
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(Phone) '1S1.. ';?</--()~f) 2- -
iIu ~tI"l( I 5"G3~
(City) (Zip Code)
(Phone) ~~ -
DATE 1-rl-/??I
Quantity
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)
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
I
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 $ ~
BuildingPermit# ()f -~ fz..1
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.50
(Office Use Only)
~ This Application Becomes Your Building Permit When Approved
Building Official
Date
I Paid ~ .A/IJ
I Da~. II,d?
ReceiPt~1r
By ~.
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24 hour notice for all iospactions (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
,--S7?r', fX4'h.Ht)A
OWNER
CONTR.
PHONE NO.
PERMIT NO.
[J FOOTING
o FOUNDATION
[J FRAMING
o INSULATION
[J FINAL
[J SITE INSPECTION
o PLUMBING RI
o MECH RI
[J WATER HOOKUP
o SEWER HOOKUP
""'-pLUMBING FINAL
o MECH FINAL
DATE
M/
'/;1
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-'Z- ?27
o EXlGRADlFILUNG
o COMPLAINT
[J FIREPLACE RI
o FIREPLACE FINAL
o GASUNE AIR TST
o
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I- WORK SATISFACTORY, PROCEED
[J CORRECT ACTION AND PROCEED
[J CORRECT WO~~~,-?R REINSPECTION BEFORE COVERING
Inspector. /~ Owner'Contr:
CAI}_ A47-RR~ FQR THE N'3XT INSPECTION 24 HOURS IN ADVANCE.
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CODE REQUIREMENTS ARE FOR YOUR PEJ/SONAL HLUTH 01 SAFETYI