HomeMy WebLinkAboutPlg Permit 05-0375
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CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
5. 4, (1.5'
I. Blue File I PERMIT NO
2. Gold City . 05, cJ J7S
3_ Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
d.~\-x ('()UB<.1( OC\.~~
;)'C\\'8 Lo'-'o.aC Ori~~
(Address)
(Contact Person) _ ~ \'Ci.. ~__..~.;a \~ ~v j
APPLICANT SIGNATURE. . J; ') U!,..---
I
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)
LEGAL DESCRu'nON (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
. (Address)
APPLICANT;;)
(Name) ~"at>
WCA.\C". r- ~u e
-1
(Address)
Quantity
PID ~s: 4-04-, (I'.l~ D
(Phone)
(Phone) C, J.,.J - ;)::J (0 " 11.( ., q
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v,"or ~\(Q 5-'),:\ 7~
(City) (Zip Code)
(Phone)
<15",,)- d)fD . 3 1./ 11./
DATE liS.] dd.L - :) '-I s q ,/-/t.,..&,
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 $
Building Permit # 0 S-. (,) ?7 5-
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
.50
40. ()f)
I
Paid 4-0 vU
Date ~ tf,cs-
,
Receipt No. #/1/ ~
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
CITY OF PRIOR LAKE ~ l
INSPECTION NOTICE SCHEDULED It; f2tt.k
ADDRESS :2'718 COcJ~ r?~ f
OWNER CONTR.
PHONE NO.
PERMIT NO.
~ ~ 3'?~
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
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
..flJ GULINE AIR ~T
JZI'- J-n "CJ ~
COMMENTS:
e
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~ORK SATISFACTORY. PROCEED
o CORfjE CTION AND PROCEED -
o CORR CT NJjfK. CALL FOR REINSPECTION BEFORE COVERING
Inspect r: ) /W Owner/Contr:
C. \It If.:;:;S50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
V .
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
/NSNOTl