HomeMy WebLinkAboutPlumbing Permit 03-1316
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
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;~: ~:~ I PERMIT NO. 03"/3/A-
3,Yellow Applicant ~
ADDRESS llogq 4
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ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT ~ BLOCK ADDITION
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I OWNER
(Name)
(Address)
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APPLICANT Dtl\..Y\' \}.J~
(Name) , ~ e
(Address) _\D \ 4 3'6.P- A\..rl 'S\U
(Address)
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'PLICANT SIGNATURE
(Phone) l., I a " 80 I - 6d ltD
\-\LA:\th I h&1Vr .55350
(City) (Zip Code)
SQ....n\.)
(phone)
(Contact Person)
DATE
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall I Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
Estimated Cost $
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Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
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.50
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/~mce Use Only)
'his Application Becomes Your Building Permit When Approved
Building Omelal
Date
Paid ItO I -
Date?;;, 9--3
14 hour notice for all inspections (951) 447-9850, fax (951) 447-4145
16100 Eagle Creek Ave., S.E., Prior Lake, MN 55371.1714
DATE tillE
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
[J FOOTING
[J FOUNDATION
[J FRAMING
D INSULATION
[J FINAL
[J SITE INSPECTION
[J PLUMBING RI
D MECH RI
[J WATER HOOKUP
o SEWER HOOKUP
,A3"1'[UMBING FINAL
[J MECH FINAL
t:JJ - /.Y~
[J EXlGRADlFILUNG
D COMPLAINT
[J FIREPLACE RI
D FIREPLACE FINAL
[J GASUNE AIR TST
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COMMENTS: / ~
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~RK SATISFACTORY, PROCEED
[J CORRECT ACTION AND PROCEED
D CORRECT WORK, CALL FOR RElNSPECTlON BEFORE COVERING
Inspector. ~ Owner/Contr:
CALL 447.9860 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
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CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!