HomeMy WebLinkAboutPlg Permit 01-1213
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
(Please type or print and sign at bottom)
ADDRESS
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LEGAL DESCRIPTION (office use only)
LOT II BLOCK ADDITION
OWNER
(Name)
(Address)
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APPLICANT LJ .. / l, / I, j" ("
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APPLICANTSIGNA~URE U4~~1
(Address)
Quantity
1. Blue File
2 Gold City
3 . Yellow Applicant
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(Phone)
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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)
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
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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 $
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
Building Permit #
_.50
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Paid ~ " &IV
Dat1tJ. U.-C!)/
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By
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
10.2-("-01 Z..!./Sf/'I
ADDRESS
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
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o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
o PLUMBING RI 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP~FIREPLACE FINAL
o PLUMBING FINAL GASLlNE AIR TST
o MECHFINAL ~
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'f;d WORK SATISFACTORY. PROCEED
(0 CORRECT ACTION AND PROCEED
:,:ECT ~~O~ REINS:::,:::EFORE COVERING
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTl