HomeMy WebLinkAboutPlg Permit 02-0631
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
(Please type or print and siRll at l.v~:""_)
ADDRESS ZONING (office use)
1. Blue File PERMIT NO
2. Gold City . /1 .1 _ /- ~ I
3. YeUow Applicant C/ t7f.. <t:A::>
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)
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LEGAL DESCRIPTION (office use only)
LOTg' BLOCK ~ ADDITION <-n:Lud../)LJ..) I ) ,'eu...>
- .
OWNER
(Name)
C.~17 k.,e fI;p/ke.U
.. . ,
(Address)
APPLICANT / /) A' /
(Name) Ae~ '1 K;;ftA ~ . ~~
(Address) ~tf- [1- ~ ~ p/~
(Address)
(Contact Person) LeoV]./'l I ~ n
APPLICANT SIGNATURE' ~ c-. ~
Quantity
~~
PID0?5 ' ,7{BL./... {YJ;). f. :>
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I
(Phone)
(Phone) 1"rol fFrff )('" fb
.~h'2~- bJ f '( :5
(tity) (Zip Code)
~)rJ- 1'33 ~ if
DATE ,t) r;- /0/ /0 2..
(Phone)
Type of Fixture
Rough- ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
)( r ~ ->, Lawn Sprinkler
" Other
FEE SL.tlEDULE
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 $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
3Q.sO
..50
LfO,OO
Paid L(tJ IO()
Da~...g I't?Y
Re:;~IIR'
By'
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CITY OF PRIOR LAKE
INSPECTION NOTICE
.,..
SCHEDULED
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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
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
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S:P""'1IC/~_
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DATE TIME
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o EXlGRADIFILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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~
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WA~LL FOR REINSPECTION BEFORE COVERING
Inspector: r V f' q.... ( () ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
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CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .( SAFETY!