HomeMy WebLinkAboutPlg Permit 06-0238
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
(Please type or print and siltll at bottom)
ADDRESS
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LEGAL DESCRu' lION (office use only) () ~ .
LOTt./ BLOCK ~ ADDITION )S.4U11MA-~
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OWNER
(Name)
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(Address)
APPLICANT / 'L . /l ,:-. )
(Name) f....,rjn-rn tJ JuA/
(Address) / 9-1) /) ff" / a.l-h
(Address)
(Contact Person) Ro.h.- ~J Y
'PPLICANTSIGNAT~RE R~11- ff4
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~. ~~ ~~~ PERMIT NO'00- ., 3 (>
3 . Yellow Applicant c;;;l 0/
ZONING (office use)
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(Phone) 95":;- ~t;7- q ~ 9, s
(Phone)
9-.b8--..I-J35'- 7~9 d
(City)
(Zip Code)
(Phone) q,C:;;Z-~~~b -7?'9/J
DATE ,7-/--4-/) t:,
Quantity
Type of Fixture
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)
Quantity
APPLICANT PLEASE COMPLETE BELOW
I
I Type of Fixture
Ro~h-ins
, W at~r Reate0
Water Softner
I 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
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Estimated Cost $. z;- () tJ :;.....-
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
(5 9J htJ
.50
./-j../) r 11 1/
Paid
Receipt No. -t:._"'l
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By
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LI"- (0-' It,
Date
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
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OWNER
CONTR.
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
.....cnsL.UMBING FINAL
o MECH FINAL
TIME
t{. --.2SrY
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMEbl;JS: / /' _ /" _ / /
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~t( SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, C::-L;J~INSPECTlON BEFORE COVERING
Inspector: ~ Owner/Contr:
- /
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!