HomeMy WebLinkAboutPlg Permit 05-0328
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Date Rec'd
'CITY OF PRIOR LAKE PLUMBING PERMIT
4. 2(PrO~
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I. Blue File PERMIT NO
2. Gold City , OS. 032,. tQ
3 _ Yellow Applicant
(Please type or Print and sie;n at bottom)
ADDRESS
/'1202 A-sD~ Av~. N.b.
,
LEGAL DESCRIPTION (office use only) Cl
. LOT 3 BLOCK:3 ADDITION~CVrtd
ZONING (office use)
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OWNER
(Name) :...Et,lXnSi }(o(..\\y
(Address) I!I2P2 A600.r1 IJv.L, N.&.
,
(Phone) Jq52)~b-3Sl/
APPLICANTN bL ~
(Name) trr ~ t'~h,(\V
(Address) 2. ,~S- UILF.(.t, Jd tHe. 6:>.
(Address)
(Contact Person) /l.,ny ,y 1> t:I+()
APPLICANT SIGNATURE ~-:7'~~_ ~
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APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
I Floor Drain
I Lavatory (Bathroom Sink)
Laundry Tray (1 or 2 compartment sink
Shower Stall
Sinks
Bar Sink
I Water Closet (Toilet)
(Phone)
Mflt>
(City)
( "z) 827 - YOJ!>
~S"1/)P
(Zip Code)
("7)327- '-/033
L/ lIS- j,s-
(Phone)
DATE
Quantity
Type of Fixture
I
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 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 #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
21.~
.50
4/1 . 07J
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid
L{O~
Building Official Date Datj;j, ;}-I)- c;-
24 hour notice for all inspections (952) 447-9850, fal952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
Rec~ ~/ d-J
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~A's ,- TIME
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.DDRESS /'/..20.2 ~erl. #Ve,
OWNER CONTR.
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
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 ~R HOOKUP
~LUMBING FINAL
o MECH FINAL
-.es--Jd
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENT~ , /' ; I / ,/
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~ORK SATISFACTORY. PROCEED
/d ~ORRECT ACTION AND PROCEED
o CORRECT WORK, CALL 0 REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
IIiSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH of SAFETY!