HomeMy WebLinkAboutPermit #01-1264
Date;Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File
2. Gold City
3. Yellow Applicant
ZONING (office use)
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ADDRESS
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LEGAL DESCRIPTION (office use only)
LOT I BLOCK ?A-DDITION
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(Address)
PID
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OWNER
(Name)
APPLICANT II /\
(Name) 11~~.h^d \..-0 n Su.J tun-fS
(Address) ----11 GJ A W1lst fYltt"1\ Sfree.t' '
(Address) f
(Contact Person) ~ \'c.t c.D r"ll\.ors
APPLICANT SIGNATURE
(Phone) q.~;l.- 7~1I-q7;l7
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( City) ( Zip Code)
(Phone) 95:2- 7~ - tf7~1
DATE
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough- ins
Dishwasher 7~J ~r Heater
Floor Drain l rNI ater Softner
Lavatory (Bathroom Sink) .)/ Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink /}y Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) 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 $ 6du
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Date
Building Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
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
F"yVj C(~
COMMENTS:
DATE TIME
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Ol-IL' ,,/
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o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
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'WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
Inspector: YYf7 ).- 27-rf3Owner/contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!