HomeMy WebLinkAboutPlumbing Permit 03-1391
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,
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
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(Please type or print and siltD at bottom)
ADDRESS 4l.\ 18 P~\J ;eLL) -rva.J.
;::: ~::y I PERMIT NO. II~ ~ rzq/. \
3_ Yellow AppliCl\llt (J.-J 1.-/
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID z.S. 33(0 , 009. 0
OWNER
(Name)
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So...vv\.A
(Phone) q6cj' d~lo' 1.o'l":f'1
. (Address)
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APPLICANT l".. ~ '- I C> "'.
(Name) uCJl\JlLU\ (Phone) -Ul~ - (\01 ~ u;)l,p/)
(Address) LI4 '1->gJl At oW ku~ 65360
(Address) (City)
(Contact Person) ~ (phone) ~
,/~ 'PLICANT SIGNATURE ~_ _ l --' ~ DATE /0 '{)l . 03
APPLICANT PLWE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
I Lavatory (Bathroom Sink)
I Laundry Tray (1 or 2 compartment sink
Shower Stall
I Sinks
I Bar Sink
I Waler Closel (Toilel)
(Zip Code)
Quantity
Type of Fixture
Rough-ins
Water Healer
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backtlow Assembly
Backtlow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
Industrial, Commercial & Multi.family 1% of job cost with a $39.50 minimum
ESlimated Cost $
IlJ~-
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
LI~OD
(Office Use Only)
~
'his Application Becomes Your Building Permit When Approved
Building Official
Date
I Paid (f-(). crz}
I Dale '>
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ReceiP~ fd
By ~
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24 hour nolice 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
SCHEDULED
ADDRESS
~~??' A~dv/~L..J
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH Rl
o WATER HOOKUP
o SEWER HOOKUP
~UMBING FINAL
o MECH FINAL
DATE TIME
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~
7Y1
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o EXIGRADlFILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENpj: / /1/ . _~ / n
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. -~/- ~~9'E-~-'
V
~..j
( JI<-
d( WORK SATISFACTORY, PROCEEO
1r;"CORRECT ACTION'iJi;ND PR EED
o CORRECT WORK, CAL REINSPECTION BEFORE COVERING
Inspector. 1ft. Owner'Conlr:
.
CALL "7-9880 FOR THE NEXT INSPECTION 2A HOURS IN ADVANCE.
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CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI