HomeMy WebLinkAboutPlg Permit 02-0926
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
(Please type or print and si2ll at bottom)
ADDRESS
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I. Blue File I PERMIT NO~ -?C~
2. Gold City
3. YeUow Applicant
ZONING (office use)
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LEGAL DESCRIPTION (office use only) (/) r '-1 _ '... '
LOT BLOCK ADDITION (j--/~f7'{1/l.e.~~
O~ER I'~ J ~ 111 1/1 n a
(Name) 0 ULLJ ~ !-J.M l
(Address) / lP.tl!l ~EJttJtV./hIt/: cS.f7.
~;;~~ANT ~ PUUTJ)2ina
(Address) 2-Q05 f;larfi eLa AVe .JDo.
(Address)
(Contact Person) Verr IJ or bl (5YVL.;
APPLICANT SIGNATURE 1{fJLJ. --
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture I 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)
-
Quantity
~
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f;.
PID r:;,,~"~IJI- 044~'
(Phone) (Cfv2)L/'-f 7 -- If-?/?J)
(phone) ({PI2-) ~?-.1" LfD7J3
m/pIS. fjfjfot
(City) (Zip Code)
(Phone) ({PI '),;) 317/ tfO?; 3
7 /~3 /01-
DATE
Type of Fixture
_ ,:R Qngh_ins
i Water Hea1;r)
VI ater 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 $
(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
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.50
t!'O,-
Paid 1/J f/f) /-----
Date -""'" . ""'I
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Rec~~ p
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DATE TIME
CITY OF PRIOR LAKE
INSPECTION+lOTlCE
SCHEDULED
)..- )./
ADDRESS
Ie (71
~Vl.s 1M.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
7-- ,^C
D FOOTING
D FOUNDATION
D FRAMING
D INSULATION
D FINAL
D SITE INSPECTION
D PLUMBING RI
D MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
~MECH FINAL
D EXIGRAD/FILLING
D COMPLAINT
o FIREPLACE RI
D FIREPLACE FINAL
o GASLINE AIR TST
D
COMMENTS:
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If'WORKSATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
D CORRE~TAW", CALL FOR REINSPECTION BEFORE COVERING
Inspector: Y'I F Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
IN3NOTl