HomeMy WebLinkAboutPlg Permit 01-0648
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2. Gold City
3. Yellow Applicant
Date Rec'd
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CITY OF PRIOR LAKE PLUMBING PERMIT
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ZONING (office use)
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LEGAL DESCRIPTION (office use only)
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PID
I OWNER
(Name)
(Address)
(Phone)
(Contact Person)
(Phone) 952- ?it/v - ~ /
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(City) (Zip Code)
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(Address) ,5 ZJ ~ f1~Pj /'c:v.F ~ 5E
(Address)
APPLICANT SIGNATURE
DATE
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (1 or 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks ~ Backflow Assembly Test
Bar Sink v Lawn Sprinkler
Water Closet (Toilet) 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 # (5/ -tJ ~
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
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.50
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(Office Use Only)
es Your Building Permit When Approved
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Date
Paid d cJ
4-0 ·
Date () /
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
SCHEDULED
DATE TIME
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CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
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o EXlGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
1 CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI