HomeMy WebLinkAboutPlg Permit 02-1490
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
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1. Blue File
2. Gold City
] Yellow Applicant
PERMIT NO'L2J_ /L/tjO
(Please type or print and sign at bottom)
ADDRESS
5'110 FI:1.i.v-~w,^- Skov-e.,.." Tv-.
ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT).../ BLOCK
ADDITION -:1 (~tw J}f .j!.ktYl JL....a.-
Able spv,:""'ldev
PID&5-D3/-003- )
OWNER /, '\
(NameLJ,,,.Ck.>!> to,..."e....- )
- #-15,-
(Phone) 9 5'.). - ()~ y 7
(Address) 5<1-;2(1 ro...l;'IAL-'J",- SkDv-e~ lVA..,'l
APPLICANT [) i
(Name) ['(61.0 .
( 4 $'30
(Address)
(Contact Person) Un..,u-e Lo~ ~~"'''' ;;lc.crS I1-t
APPLICANT SIGNA TURE ---'f)~ d ~~.A-
(Address)
f;?oofcV' Sev.v. Co
~ 7fk Av-e tJo
(Phone)
p~ ~~L
(City)
tic?:' - S5~ -3 '5;;... 2....
(Phone)
s-s'l</7
(Zip Code)
(lD3'-~/7-3C;oY
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DATE
/0 -30,.D)....,
Quantity
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (1 or 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
Type of Fixture
I
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backtlow Assembly :IV'';~!/~....-I::.~
Backtlow Assembly Test U
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 $ 3.$'0. {.$)O
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
3 9. -<'""
,50
~4oo
(Office Use Only)
Building Official
Date
Paid Ji ../
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Date ;l-
Receipt N9:., /l
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This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
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ADDRESS
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
2 -ILf~O
o FOOTING
o FOUNDATION
o FRAMING
o INSULA nON
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
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~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~R~~L FOR REINSPECTION BEFORE COVERING
Inspector: (V I" 1--lt-~er/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSl'iOTl