HomeMy WebLinkAboutPlg Permit 05-0059
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File PERMIT NO () 69
2. Gold City . 'r-
] Yellow Applicanl J
~ase type or print and sign at bottom)
ADDRESS
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J~ve
St-
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOTti BLOCK 3ADDITION
PIDd5/ 0/1'01/7"6
OWNER
(Name)
~uantity
04" Ko (Phone) if)) -If'11-tj"rSK
J ~ 7'8~ Lv ()~s Pv~ _(~ r ~<;n'L
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c,ith...v fJe,w"..b.) L LC (phone) 9\';. If/{7 .fO),)
;;~lIf /0-j~ ~ lJ ~w~., 5~/7~.(. ST31r-
(Address) (City) (Zip Code)
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APPLICA-NT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
Type of Fixture
fYlvv1,v
(Address)
APPLICANT
(Name)
(Address)
(Contact Person)
APPLICANT SIGNATURE
\
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
I Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
Industrial, Commercial & Multi-family I % of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.50
(Orner Use Only)
Building Official
Date
Paid J / ___
'70- ,
Oat. e rt:
-./ - ::J.f)- OJ
Receipt No. -17"
VytJ 5"""6
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This Application Becomes Your Building Permit When Approved
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
SCHEDULED
ADDRESS
~?F~ Ly~S
J /'
CONTR.
OWNER
PHONE NO.
PERMIT NO.
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
~UMBING FINAL
o MECH FINAL
COMMENTS; / / -'7 / /
{A/qn,-- #~o/rer
~ / /
( 6~ $JU--5 7; 64-
0)/
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DATE TIME
. ?/.;f~
CJ~-C?
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
,//
/7/}-
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO,}~~WR REINSPECTION BEFORE COVERING
Inspector: /~./- Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
/NSl<<JTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &; SAFETY!
DATE TIME
(b:/oJ~
L}0~ ~p,
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/f,7c?</'-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
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
~MBING FINAL
o MECH FINAL
a)- S-?
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS/:? /' / ,,/ /' / /
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(I/) /1/f?~A t'O~60,h~
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:ftJy /ee / X~toL/-r--/O~
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
fl.ORRECT WORK~ 9f7b*~NSPECTlON BEFORE COVERING
Inspector: ff N Owner/Contr:
/ v
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
/I'ISJIIOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!