HomeMy WebLinkAboutPlumbing Permit 04-0802
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CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
1 z..-&l,of-
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1. Blue File I PERMIT NO I
2. (JQ1d C;'Y '0+ . ()tJOZ-
3. Yellow Applicant
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I ADDRESS 166~o ~~
Av-e
I ZONING(o_use) I
LOT
LEGAL DESCRIPTION (office use only)
BLOCK
ADDITION
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APPLICANT ~ \ . '~ '-1"'\ A
(Name) uEt-... '~~ \.AJ ~ (phone) W CI' l?D1-6;)ltJu
lD \L\ ~ All fij 1 k~it.kuJft",. 6Q~
(Address) (City) (Zip Code)
(Contact Person) ~ \ KK1 \. U * (Phone) ~ I ;J - 'g'{P'iS -l.( l.f 6 ~
APPLICANTSIGNATURE~ ' . \---'." \ DATE
APPLICANT PLE..bJ COMPLETE BELOW
Type of Fixture Quantity I
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 Backflow Assembly Test
Bar Sink ~ Lawn Sprinkler
Water Closet (Toilet) Other
OWNER
(Name)
(Address)
(Address)
~
Quantity
(Phone) 'ftJd -l/!:L, " -1d I;:)
Type of Fixture
FEE SCHEDULE
Industrial. Commercial & Multi-family 1% of job cost with a $39.50 minimum Residential, New One & Two-Family 599.50
Residential. Additions & Alterations $39.50
Estimated Cost $
Building Penn it #
0+.0 eOz-
~9.60
.50
~O.ul
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
J This Application Becomes Your Building Permit When Approved
Paid 4<J . W
Date7.] (). O~
Receipt N~76 7:?
By f'
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., PrIor Lake, MN 55372-1714
DATE nME
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ADDRESS /S:Sf'S L !;eHr~h ;I ~e
OWNER CONTR.
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING Rl 0 EXlGRADlFILLING
o FOUNDATION 0 MECH Rl 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE Rl
o INSULATION 0 SEWER HOOKUP 0 FIREPLACE ANAL
o FINAL ..-I!f1liUMBING FINAL 0 GASLlNE AIR TST
o SITE INSPECTION 0 MECH FINAL 0
COMME~: J IV A / /J
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A ~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~~1JiDR REINSPECTION BEFORE COVERING
Inspector. /~ Owner/Contr.
r
CALL "7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAl. HEALTH .. SAFETYI
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