HomeMy WebLinkAboutPlg Permit 02-0776
Date Rec'd
CIT~.9F PRIOR LAKE PLUMBING PERMIT
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L Blue File
2, Gold City
3, Yellow Applicant
PERMIT N<n)..- '7'1 A,
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(Please type or print and siJ!)l at bottom)
ADDRESS
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ZONING (office use)
R. f 5f)
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FtUAi74-1J~ 4/v
LEGAL DESCRlt'uON (office use only)
ADDITION ~ p~ ~..dLL- PID~S-t?3t:,-(j/3-<'? "
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LOT /LfBLOCK
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OWNERg __ \
(Name) ~~l<..v\. \l~ \"'f
(Phone) 9 s::;~ y ~ '/- ~ a 0 ~
(Address)
APPLICANT
(Name)
(Phone)
(Address)
(Address)
(City)
(Zip Code)
(Contact Person)
APPLICANT SIGNATURE ~ ~..c..&().-. .....~
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(Phone)
DATE
'/e:>7 b "Z-
Quantity
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture I Quantity Type of Fixture
Bath Tub with or without shower I ./ Rough-ins
Dishwasher if Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (1 Sewage Ejector
Shower Stall REQUEST FOR INSPECTION Backflow Assembly
Sinks SENT TO HOMEOWNER. NO Backflow Assembly Test ---
Bar Sink RESPONSE - CLOSE FILE Lawn Sprinkler
Water Closet (To 4/2003 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 $
~q 5"0
.50
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(Ornce Use Only)
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Building Orneial
Paid liD. crD
Date 10 I;)'l / OCJ-
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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
Date
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BY~
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This Application Becomes Your Building Permit When Approved
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
"EJ FINAL
(0 SITE INSPECTION
COMMENTS:
DATE TIME
'-
7- ~- d-.. .;1; 90
~;~~
SCHEDl')..ED
.
/5 d 63
CONTR.
PERMIT NO.
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o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
/J~ 'lJfr--.
mn-+ ~i-~V?
~ /otdl€-'
o EXlGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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~ ~ ~_ ~ v.J~ l-Z; f 1 ~ ~
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
)t CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
'''pector: ~ . QwoerlContc
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl