HomeMy WebLinkAboutPlg Permit 02-1126
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(Please type or print and sign at bottom)
ADDRESS
17 a~L( b.1rr O~ LJJJJe 6e.
I. Blue File PERMIT NO ~
2 Gold City '/"y_''''' _. J'j , .
3 Yellow Applicant ( k-J ."
ZONING (office use)
12/
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,(Address) 17 ~~L/ bUrr OQJL J-f7. 6t.
APPLICANT N hI b '
(Name) orb' om r lium . , na
(Address) :;Lqo 5 otLr-fi tld ./lY; JSO.
(Address)
,,-Je fi tUIlrJ2l1m1
LEGAL DESCRIPTION (office use only)
Lol~ BLOCK l/ ADDITION
PID ~ 37o-039-,'c)
(Phone) {q5~)4 Llo-- /;;'40
(Contact Person)
(Phone) (LPI-:2) 81-7-4033
m D/<)j 554 oX'
, (City) (Zip Code)
(Phone) (Lt 12) ~77;" 403!:>
DATE S/JI!D;J.,
APPLICANT SIGNATURE ~/\---
7'7); ~
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (I or 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
Quantity
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
.t}.m 00
Estimated Cost $ ~. ,-
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
m. fJE
.50
tfO, or
(Office Use Only)
Oate
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9-!0- d-
Receipt No. ~;;;,
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By
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This Application Becomes Your Building Permit When Approved
Paid
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
CATE TIME
( OF PRIOR LAKE q -ft,<Jj
INSPECTION NOTICE SCHEDULED
ADDRESS 17}1-L( (JcJrr ()c..1t LAV1..c-
OWNER CONTR.
PHONE NO. PERMIT NO. 'J-- (IJ-~
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 EXIGRADtFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
La W 11\
'hr
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~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: r!\!f q ~/~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSJ(Ofl