HomeMy WebLinkAboutPlg Permit 04-0175
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(Phone) (15 0)~ LP-Qa60
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(City) (Zip Code)
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. REQUEST FOR FINAL
Bar Smk
Water Closet I INSPECTION SENT TO
HOMEOWNER 01-06
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 01-05
(~\\f'~Pb--r ~
(Please type or print and sign at bottom)
ADDRESS '
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LEGAL DESCRil' nON (office use only)
LOT2JBLOCK / ADDITION /I?~,w0eh/
OWNER "'-
(Name) ,bE' 1=\\\
(Address) ;::; L\ 71,
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APPLIC~T rl-n .
(Name) <:t- \.. '~Ql'l
(Address) t:=) -, ~ {\-h J ~ri
. -(Address)
(Contact Person) ~\JY\
r?PLICANT SIGNATURE ~ ~./T
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Quantity
Industrial, Commercial & Multi-family 10/0 of job cost with a $39.50 minimum
3.24~04-
Blue File PERMIT NO
Gold City 'Ottl.Ojrl5
Yellow Applicant ,...
ZONING (office use)
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PID z.&.384---. o oS. 0
(Phone)
DATE
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Type of Fixture
I
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Pennit # tJ ~ . ~/7.s--
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Offiee Use Only)
.( ',.his Application Becomes Your Building Permit When Approved
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\ ) Building Ornelal
----
Date
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.50
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Paid-HJ. c/U
Date? ..... L.
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Receipt No.
BY~
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24 hour notiee for all inspections (952) 447.9858, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake. MN 55372-1714
DATE TIME
CITY OF PRIOR LAKE -d Ii'll
INSPECTION NOTICE SCHEDULED vrf!2;, 0 (,
ADDRESS Z1./3T'] $-\-O~ ~'
OWNER CONTR.
PHONE NO.
PERMIT NO.
-
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o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
~EWER HOOKUP
~LUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASL1N~.6,t~ TST
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COMMENTS:
(\\~ -Q (t
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRr1 WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspectr;{:\/ ~ Owner/Contr:
C\'(l J7~850 ~R THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE RE~~ENTS ARE FOR YOUR PERSONAL HEALTH .{ SAFETY!
INS/VOTl