HomeMy WebLinkAboutPlg Permit 06-0682
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
1. 2- J. ()(p
I. Blue File I PERMIT NO
2 Gold City . 0 / . () 6 B z-
3 Yellow Applicant (('
(Please type or print and si2l1 at bottom)
ADDRESS
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G-c\., l. ~ y\CG \' (Phone)
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APPLICANT f\ "_ () _ 1 )~.,
(Name) "UfQ I r ~ 'fJ .,' ,
(Address) 7f'~l,) ;;(() 9 --rh .
(Address) (City)
(Contact Person) c \~J l ,(l.A ... -:" (Pjrye)
A..PPLICANT SIGNATURE U.hru / 'tI-ctY'v1~ DATE
I / t
APPLIC~T PLEASE COMPLETE BELOW
Type of Fixture I Quantity
Bath Tub with or without shower I
Dishwasher I
Floor Drain I
Lavatory (Bathroom Sink) I
I Laundry Tray (lor 2 compartment sink I
I Shower Stall I
I Sinks I
I Bar Sink I
I Water Closet (Toilet) I
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
.J(G\ \' '0
\ L\ 10 '(;l'
(Address)
Quantity
ZONING (office use)
PID aJJ:/Jrr _ O() 1: ()
'-/1/1 -3q 6-r
(Phone)
LaJi ell (II€-
?SJ-L/bq -6991
5S() Lit/'.
(Zip Code)
9Sa-t.Jh9 --6q CJ l'
7-c1'-1-{J 0
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
I Sewage Ejector
I Backflow Assembly
I Backflow Assembly Test
Lawn Sprinkler V { 8
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
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Estimated Cost $ -1.J I 0
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
39.SV
.50
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(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
I Paid 41;. t-1J
Date1 1",/
/y.,6
I Receipt N.3;7ff" d-
j
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
DATE
oA~6
"
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
CONTR.
OWNER
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
~LUMBING FINAL
o MECH FINAL
TIME
.h - -CJ' J-
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMZu-",- Y;;~c:e r.:;~_
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/ss~ /070
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~TISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT wo~r'NSPECTION BEFORE COVERING
Inspector: / ~{ ~ Owner/contr: .
, --
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl