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HomeMy WebLinkAboutPlumbing Permit 03-1597 ---------------- CITY OF PRIOR LAKE PLUMBING PERMIT 1Z-./~.03 " REQUEST FOR FINAL , . INSPECTION SENT TO .~.~v~t~-and-It--L. '. .0. W..N. E.R. 01-05 AD~ HOME. _._ ... 190 . . ..--.::..rDiHr ~0~ LEGAL !DESCRIPTION (oftIce use.,.,ty) LOT BLOCK Au1J1UV1~ Date Rec'd 5.. !'_I PERMIT NO. Cf./597 I ZQN!NG(_....) J Je~O PID zS: 03". 001.0 tSR.u.CLUl ~ (phone) M.z- 'b7- <{q~ (A~ 1521:11 ~ltbw\'~ 11LL W. _~.l.uJc,. ~ SS3n J .- ~~~.\\ .Q'-. ~i~lN.~ . (phone) J."C;;/- 2..loS- B{(Q (Addres~) ~() ~ '""Kc\ . 7.1l6.- ~ tl\L-\ SS1~J,. (Address) . U' (City) (Zip cooer' (Contact Person) ~ ..-+-..\ 1. - (phone) ~ APPLICANT SIGNATURE ~--h~. DATE . 1:>r-1/( I n~ r. APPLICANT PLEASE COMPLETE BELOW ,. ~ . Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough-ins Dishwasher f Water Heater Floor Drain Water Softner I Lavatory (Bathroom Sink) Stand Pipe (Washing Machine) I Laundry Tray (lor 2 compartment sink Sewage Ejector I Shower Stall Backflow Assembly I Sinks Backflow Assembly Test I Bar Sink Lawn Sprinkler I Water Closet (Toilet) Other OWNER (Name) · FEE SCHEDULE Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum ~~ Estimated Cost $ 0100 ,/ Residential, New One & Two-Family $99.50 Residential, Additions & Alterations $39.50 BuildingPennit# 03./597 .:;5.50 . 50 Ut) .<8- PLUMBING PERMIT FEE $ STATE SURCHARGE $ TOTAL PERMIT FEE $ (omce u.. Only) .+. This Application Becomes Your Building Permit When Approved , .\ I Building omctl. Dlte paid40. (J 0 Date I'Z-. If;. 43 Receipt ~~ CJ 8 z.. BYp- 14 hour Dotice for allln ,', .. f . ,., (951) 447-9850, fas (951) 447-4145 16100 Eagle Creek Ave., S.E., Prior Lake, MN 55371-1714 CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED ADDRESS IS" )..() 't Fu,:.-kt",k ... OWNER CONTR. PHONE NO. PERMIT NO. o FOOTING o FOUNDATION o FRAMING o INSULATION o FINAL o SITE INSPECTION o PLUMBING RI o MI'CH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MI'CH FINAL It)-o It-tl\ k,- COMMENTS: - .--- ( /' / In~ L--IV ---- ) DATE TIllE r-(]-rC -r,.-I. ,q, o EXIGRADlFILLING o COMPLAINT o FIREPLACE Rl o FIREPLACE FINAL o GASUNE AIR TST o ~ 1 I \ t (I...D. ) ./ -- ----. ~ATlSFACTORy.PROCl'ED o CORRECT ACTION AND PROCEED o CORRI'CT ~~~FOR RI'INSPI'CTION BI'FORE COVI'RING Inspector. f/I/T OwnerlContr: CALL "7-9850 FOR THE NEXT INSPECTlON:U HOURS IN ADVANCE. -, CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI