HomeMy WebLinkAboutPlumbing Permit 04-0527
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CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
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(Please type or print and sign at bottom)
I ADDRESS <
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i:: ~:~ I PERMIT NO.)\ A .0&:711
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I I ZONING(Olliceuse) I
LEGAL DESCRIPTION (office use only)
LOT BLOCK
ADDITION
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OWNER
(Name)
Dc.o-H Few l e..v
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(Phone)
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(Address)
APPLICANT
(Name)
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(Address)
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(Phone) to I d -~ I - 5;;)lt()
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(City) (Zip Code)
101 a -~~ '440(0
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(phone)
(Address)
(Contact Person)
<\.PPLICANT SIGNATURE
DATE
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 comparbnent sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks \.L7 Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
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APPLICANT PLEA
COMPLETE BELOW
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 $
Building Permit # 04. &.52.--7
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
6'1,Cf)
.50
4() ,00
(om.. Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
paid"fd. &1(;
Dall~.. 1..-.0 4---
Receipt No~ 97 (l
By
14 hour notice for an inspections (951) 447-9850, fax (951) 447-4145
16100 Eagle Creek Ave., S.E., Prior Lake, MN 55371-1714
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
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OWNER
DATE TIllE
SCHEDULED ~~~
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CONTR.
PHONE NO.
PERMIT NO.
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o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
....J'H'tOMBING FINAL
o MECH FINAL
o EXIGRADlFILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS: ~
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~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector. ~~ Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH 01 SAFETYI
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