HomeMy WebLinkAboutPlg Permit 01-0808
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ADDRESS
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LEGAL D;ESCR.1r uON (office use only)
LOT f't bfbcK ADDITION
APPLICANT ~.IJ (f) ~L 11'2
(Name) V,v'P Y 'CI ~
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(Address) /'
OWNER
(Name)
(Address)
(Address)
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
1-31-0 I
1. Blue File
2. Gold City
3. Ye!low Applicant
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M1VN MVe-.PIL-.
PID ZSr027-0/tJ,.0
(Phone) ~~7- /~t!J
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(phone)
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(City)
(Phone)
(Zip Code)
(Contact Person)
APPLICANT SIGNATURE IJ~ ~
Quantity
DATE
7~c#o r t?/
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
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 # -.tJ 1- oB of)
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
35;~'7J
.50
'Yi).PO
(Office Use Only)
This AP~m.. Your Building p:;; ~.h~U ;pproVed
M~~cial , Date
Paid 4 (J . () 0
Date
1 r '3/-(/ I
BY~ ~
Receipt NO~3'(1.3
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
DATE
CITY OF PRIOR LAKE
INSPECTION NOTICE
TIME .~
if;ou
ADDRESS
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S-'1~ ()~G&e
CONTR.
SCHEDULED
OWNER
PHONE NO.
PERMIT NO.
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[J FOOTING [J PLUMBING RI
[J FOUNDATION [J MECH RI
[J FRAMING [J WATER HOOKUP
[J INSULATION [J SEWER HOOKUP
[J FINAL [J PLUMBING FINAL
[J SITE INSPECTION [J MECH FINAL
COMMENTS: ~ ~, ./
,
[J EXIGRAD/FILLlNG
[J COMPLAINT
[J FIREPLACE RI
[J FIREPLACE FINAL
[J GASLINE AIR TST
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~K SATISFACTORY, PROCEED
[J CORRECT ACTION AND PROCEED
[J CORR~RK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: f.P- . Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
lNSNOTl
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