HomeMy WebLinkAboutPlg Permit 03-1330
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
I. Blue File I PERMIT NO ~ 0
2 Gold City . /fl3 - J3
3. Yellow Applicant L-/
(Please type or print and sign at bottom)
ADDRESS ZO.J:ijN/G (office use)
o/~15 C/l€S~Vr' C/J (<
LEGAL DESCRIPTION (office use only) IV -~ <
LOT i BLOCK '-/ ADDITION ( !Il/J/U.,/1q 0 a ilo
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OWNER
(Name)
.e If IC):;
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S'~/ /1.s7UO
CH~W ~~ ~ PJI('/p/€
(Address)
APPLICANT / . v,
(Name) GH~
(Address) ---.Ot/69
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Z / .JJ ~11-J..i
(Address)
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9
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(Contact Person) /?IP-/2 L-
)PLICANT SIGNATURE ~ ~
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PIDc;?.5 - 3/ Lj - 06.;2.-d
(Phone) 9S.2- ~Y7 .. S~~b
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(Phone)
R9:1/- 76oc>
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(City)
S-S'37t?
(Zip Code)
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(Phone)
DATE
./~/ 1/0..5
APPLICANT PLEASE COMPLETE BELOW
Quantity I Type of Fixture I Quantity I Type of Fixture
Bath Tub with or without shower I Rough-ins
Dishwasher I Water Heater
Floor Drain I Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
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
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 Pennit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
'his Application Becomes Your Building Permit When Approved
Building Official
Date
Q $'c
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4.-
.50
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Paid , ...--""
'I IJ_
Date I tJ .,. 3-3
ReceiQ5:~g/}
BB
24 hour notice 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
DATE
SCHEDULED ~~
--149 5 (!J.ruf-~
TIME
A.{,
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
tJ7-/..:?!a
o FOOTING
o FOUNDATION@
o FRAMING
o INSULATION
FINAL
~ SITE INSPECT N
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
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'~ WORK SATISFACTORY. PROCEED
J CORRECT ACTION AND PROCEED
o CORRECT w;;t;.. CALL FOR REINSPECTION BEFORE COVERING
Inspector: / ';:}-y- ( Owner/Contr:
CALL 447-9;5; JOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSNOTl