HomeMy WebLinkAboutPlg Permit 01-1042
CITY OF. PRIOR LAKE PLUMBING PERMIT
Date Rec'd
LEGAL DESCRIPTION (office use only)
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(Address) W~n ~n 1>rtf11
(Ad ess)
(Contact Person) t0ffi1t~. ffiowY
APPLICANT SIGNATURE ~"JJ.L/
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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 (1 or 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
(Please type or print and sij!;ll at bottom)
ADDRESS ('\/\ ,I n. '/1 ..1n: :
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OWNER
(Name)
(Address)
v
Quantity
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1. Blue File
2. Gold City
3. Yellow Applicant
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(Phone) ~-~
(Phone) ~- Lf4~,0W
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- (Zip Code)
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(City)
(Phone) fA 0 I
DATE
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 #
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
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.50
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CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
~ . <</-. a 7.. .3: crU
ADDRESS
5CJ,OS te//~OOD ~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
CONTR.
~. (}2--001&5"
. .f'i OT 8J mIl'
PERMIT NO.
o PLUMBING RI 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKij)U 0 FIREPLACE RI
o SEWER HOOKU 0 FIREPLACE FINAL
o PLUMBING FIN 0 GASLlNE AIR TST
o MECH FINAL ~ Hz., ('J 1"'I71e-.
rI~ 0 .r()~r.
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~WORK SATISFACTORY. PROCEED
( ; CORRECT ACTION AND PROCEED
o CORRECT W , CALL FOR REINSPECTION BEFORE COVERING
Inspector:
,
Owner/Contr:
CALL 447.9850 R THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI