HomeMy WebLinkAboutPlg Permit 02-1595
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
1. Blue File
2. Gold City
3 . Yellow Applicant
PERMIT NO.O~-15)t5'-
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ADDRESS
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ZONING (office use)
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LEGAL DESCRIPTION (office use only)
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OWNER
(Name)
(Address)
APPLICANT
(Name)
(Address)
(Contact Person)
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(Phone) [;12- ~,- 4o~2-
CULLlGM\l Y'J.!\
6030 cr A
MINNETONi(P" ';'~:.,SJ'T5
_ (..Q52) 933-7200
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(Phone)
(City)
(Zip Code)
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(Phone)
APPLICANT SIGNATURE
DATE
//-Z/,-~2-
Quantity
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)
Type of Fixture
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
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Estimated Cost $ (7Vl.I
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
3Cf6o
.50
40.00
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Date
Paid 'It) p-J ReceiPt~~D1
Date -0" ./ I By iI /:'C' )
l'd.-fir rr- (-1C./
Building Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
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CITY OF PRIOR LAKE
INSPECTION NOTIOE
ADDRESS
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DATE nME
SCHEDULED I Z -31-{/7 2:>,
06~J ~U& ~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
2- )S-~
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
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
...g ~L1NE .\I~ TST
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COMMENTS:
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~ORK SATISFACTORY, PROCEED
o CORR~T~ND PROCEED
o CORR \ ;i ' LL FOR REINSPECTION BEFORE COVERING
Inspector: ,./. . Owner/Contr:
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CAL",~.7-riSO FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSN077
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