HomeMy WebLinkAboutPlg Permit 02-1586
Date Rec' d
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File
2. Gold City
3. Yellow Applicant
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PERMITNOO~ _15'g~
(Please type or print and si2ll at bottom)
ADDRESS
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V
ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LO~BLOCK ADDITION l!Jouddm
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PID;2Z:;- //fl" t't:)..ll-C.)
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(162\ CJ'/1-SJ5'1
OWNER /"') L ~
(Name) l.JZ OU~. v€.II\n-,S
.
(Address) 1441& W~edcy-Ir. N.E,
APPLICANT.. \ b\ - ~\ L
(Name) '" or \OW\ \' UNY'\O\~g",
(Address) 21 05 b~e,lcJ Ave ~c5o.
(Address)
(Phone)
(Phone)
Mp\s
(City)
(lol2) 'SZ 7 - '/033
5S-~ 0'8
(Zip Code)
(Contact Person) (Phone)
APPLICANT SIGNATURE ~~.---:-J _ DATE
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)
lLI"/~z-
Quantity
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backtlow Assembly
Backtlow Assembly Test
Lawn Sprinkler
I 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 $ Lf Ol> ~
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
6~'SV
.50
40 . ()O
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
paid4'~ J -
Date MI')/O?
Receipt No. ...J
tI.CiJ 70(~
BQe-
,
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
CITY OF PRlDR LA~ DATE TIME
INSPECTION NOTICE SCHEDULED Il-/~
ADDRESS /'14/S' Lv t4v-s erI0 <:
OWNER CONTR.
PHONE NO. PERMIT NO. 0). -1!1f"
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COMMENTS:
o PLUMBING RI 0 EXIGRADIFILLING
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 FINAL 0
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o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
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"WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector: ~ / L- t<6'/~er/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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