HomeMy WebLinkAboutPlg Permit 02-1234
Date Rec'd
-S1 73
CITY OF PRIOR LAKE PLUMBING PERMIT
PERMITNOh~
fiONING (office use)
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I. Blue File
2, Gold City
J _ Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS
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LEGAL DESCRIPTION (office use only)
LOT (l BLOCK 3 ADDITION
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OWNER
(Name)
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(Phone)
(Address)
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(Address)
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APPLICANT SIGNATURE t.h . L l..)... ILl-
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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 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
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(Phone)
(City)
76 'J-}P'Y -07S-;:<j
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(Zip Code)
(Address)
(Contact Person)
(Phone)
767-;;1'6 - O/YS-
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DATE
Quantity
Type of Fixture
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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 $
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.50
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(Office Use Only)
Building Official
Receipt No. /'
4).96 ,j
Date -:1 1"'1 ~ By /1 ")
Date 10 (7\' 00---' ~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
Paid
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This Application Becomes Your Building Permit When Approved
CITY OF PRIOR LAKE
INSPECTIOt~ NOTICE
TIME
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DATE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
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o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI 0 EXIGRAD/FILLlNG
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GAS LINE AIR TST
o MECH~L 0
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COMMENTS:
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~ WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: Ifllf 10/3- oL- Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI