HomeMy WebLinkAboutPlg Permit 05-0173
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
3.{.05
I. Blue File
2. Gold City
3 . Yellow Applicant
PERMIT NO. 05.0/73
(Please type or orint and sil!;ll at bottom)
ADDRESS
ILf&1U fI/endal6 /tV€; &
ZONING (office use)
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LEGAL DESCRIPTION (office use only)
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LOT ~ BLOCK
ADDITION OA/4-fY/'Jf) (J~ 2rJ'?
PID ~,5. 130. 003.0
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(Address) /4(;71/ (:[ { endale
1~;;~~ANT No rh 1 0YYl :Plumbinq
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(Address) 1S{05 [lar-Ei.llld AYtV 6D I
(Address)
(Contact Pcrson) Am j 0 r P CLu,,(
\PPLICANT SIGNATURE 'c:;fl ~
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APPLICANT 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)
(Phone)
(PhOne)~
(LfIJ- J'J-?J1-q,OI-
(t.P/2-) t~1 ~'-IO??J
5540<6
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(tity)
(Zip Code)
(Phone) ([P (2-) rZ,7 - tj 0 Q3
DATE 212-'6/ P5
Quantity
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
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 $
LfOO. c~
Building Permit # 05. 0/73
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
~.s.o
. .50
1-/-0. eo
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid 4-0.00
Date 3. 7. OS
Receipt No. +fJt30
BY_
/
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 TIME
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
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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
-a-PLUMBING FINAL
o MECH FINAL
c5S- -- / 7j>
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
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~ 3ATISrACTQR~. PReeEEe -------
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.
lNSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!