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HomeMy WebLinkAboutPlg Permit 05-0446 CITY OF PRIOR LAKE PLUMBING PERMIT Date Rec'd S-;IB~O~ I. Blue File I PERMIT NO, 4-~ 2, Gold City ], Yellow Applicant e>') " ')P /~13/ 1f/6I1IV/lY/Y ZONING (office use) Jet ~O LOT LEGAL DESCRIPTION (office use only) PID I OWNER (Name) (Address) z.s,": 'ldZ ozl, 0 , - BLOCK ADDITION APPLICANT (Name) (Address) (Contact Person) ~ ~\ I S "A '" r (Phone) ~ I ftJ L, "Le -::j)/<.:JVY\ jp, ~ S S?? S- I ;rJ e J:U.JOAJ <., A r?. Ie. (Address) I1rJrtlL (Phone) 9r-~- Y'Y'O !f2 b I L W ff"OI<.. LIJ/c~ 5S"'3? "'- (City) (Zip Code) (Phone) ~/(~/ oY DATE ~PPLICANT SIGNATURE Quantity 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 Backtlow Assembly Backtlow Assembly Test Lawn Sprinkler Other prt / rz. ~('Jt:Jdc- FEE SCHEDULE Industrial, Commercial & Multi-family 1% of job cost with a $39,50 minimum ,-,---'..---,_.._.. T .., ,- ..-.... .. Residential, New One & Two-Family $99.50 Residential, Additions & Alterations $39,50 Estimated Cost $ Building Permit # , PLUMBING PERMIT FEE $ STATE SURCHARGE $ TOTAL PERMIT FEE $ .50 "fbr - paid4P~ C/O Dat~-II~. ,,' r Receipt Ncrtfj>(96 By 4 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714 CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED ADDRESS / G /31 /+"fIof /-;, S f OWNER CONTR. PHONE NO. PERMIT NO. o FOOTING o FOUNDATION o FRAMING o INSULATION "'FINAL n SITE INSPECTION o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL hvte< COMMENTS: DATE TIME ., E. .'" S-~'O,J S-4/ L .,. t.J L{ l. o EXIGRADIFILLING o COMPLAINT o FIREPLACE RJ o FIREPLACE FINAL o GASLlNE AIR TST o hv1le . -.I- Irr.J. k, Ok'~ ~ORK SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED o CORRECT WO"Vr'R REINSPECTION BEFORE COVERING Inspector: Vi Owner/Contr: CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE, CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .I SAFETYI _OTl ---'-'-'---'~-'---'._'_.--'-'-"