HomeMy WebLinkAboutPlumbing Permit 03-1177
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(Phone) l, \ ;:) - K/) \ - 5;;) to ()
Hu.-tc hU\l\O\-\ 6 n"16O
(City) (Zip Code)
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APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
I Floor Drain
I Lavatory (Bathroom Sink)
Laundry Tray (1 or 2 compartment sink
I Shower Stall
I Sinks
Bar Sink
I Water Closet (Toilet)
(Please tvDe or orint and sien at bottom)
I ADDRESS \ 4~ <gO Wo.--teY5 &Jof- I va..:...l
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name) .
(Address)
Ku...v+ kC~
5o...M.R
APPLICANT
(Name)
f\~~ t'\ W~c\~.
L, \4 ~ ~ I\\t{. ~I
(Address)
(Contact Person) t\~
f -4.PPLICANT SIGNATURE ~ ~
(Address)
Quantity
\
9.~. Of
i:~ ~::y I PERMIT NO. ~ '7 -1177. I
3. Yellow Applicant I V-J
I ZONING (officeu,,) I
PID
(Phone) lol;)-lo \q -ll~{f
(Phone)
8l.M..t
DATE c,."Z.. 0."'1.
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
I Other
FEE SCHEDULE
Industrial, Commercial & MuIti~family 1% of job cost with a $39.50 minimum Residential, New One & Two.Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
'loO~
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Ornee u.. Only)
r,ThiS Application Becomes Your Building Permit When Approved
2ff .5D
.50
40.Q)
I Paidft'. (/l)
I Dat'9. s: OJ
Receipt N':f6Z,11
By d-'
T
Building Official
Dat~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
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OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
DATE T1ME
SCHEDULED J.'~~--
1 ~~
~H"sed9'e 1/1
~
CONTR.
PERMIT NO.
~- //77
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
~UMBING FINAL
o MECH FINAL
o EXIGRADlFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASUNE AIR TST
o
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//WORKSATISFACTORV, PROCEED
t;; ~ORRECT ACTION AND PROCEED
o CORRECT WO~ C)~R REINSPECTION BEFORE COVERING
Inspector. 1'f1-/// Owner/Contr.
,
CALL "7-9850 FOR THE NEXT INSPECTlON:U HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH" SAFETY I
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