HomeMy WebLinkAboutPlg Permit 02-0182
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PEMIlI
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1. Blue File
2. Gold City
J. Yenow Applicant
I PERMITNO.a:z?/g~ I
(Please type or print and siRll at bu..~~)
ADDRESS
/ ~~t)5
'~/'riat )116AJ+-
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ZONING (office use)
PIS!)
LEGAL DESCRt.l" uON (office use only)
LOn3 BLOCK ~ ADDITION-titJffYt J 11 P cnrI
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(Address)
Pa-lfv 50 1,.5
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.5 evm ('l
PID:) 5..... /ss- - ()(J5:- 0 .
(Phone) ClS-,).- '/'/7- '-ISK0/
OWNER
(Name)
APPLICANT 4::J PI
(Name) P e.-.:3 ma..1U <J :-
(Address) I ,~~;5' P ~oz:l
(Address)
(Contact Person) Gb-~' I~~~
APPLICANT SIGNATURE 1/_1_ J. A -c,r--
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APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 comparbnent sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
~ (~hOi!J~V~
(City) (Zip Code)
(Phone)
J./f).. -$,. 9'Y 0
C? I C7-U1/C>~
DATE
Quantity
Type of Fixture
x
Rough-ins
Water Heater
Water Softner
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
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
3f1 ,50
.50
L/6 I (Je)
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
pa..i~d . 00
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Date J.- ;;lb- D;t
Re~a5~
BYBU
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
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CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE
SCHEDULED
-
3./I.o,=- 1':tJ1J
TIME
-
ADDRESS
/.:SZ, oS- /2?A.o GtE7'? 0 N I
OWNER
CONTR.
PHONE NO.
PERMIT NO.
Z -/~I
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
o PLUMBING FIN
o MECH FINAL
o EXlGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TS.l
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COMMENTS:
If
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.,
~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT nALL 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 & SAFETYI
INSIVOTl
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~CE PERMii
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