HomeMy WebLinkAboutPlg Permit 05-0236
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
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(Please type or print and sign at bottom)
ADDRESS
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 01-06
~!~ PERMIT NO.()5. {)z3(P I
)w Applicant
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ZONING (office use)
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......
LEGAL DESCRIPTION (office use only)
LOT II BLOCK '7- ADDITION 1ft. V'I E- yV / <:;r
PID 2~ . I 4-3 . () '::,' o. 0
OWNER
(Name)
kr-l ShnrA{) pot
2JAv N'p M \-J
P ,ptWDY)CS
Docld Qd
(Address)
(Contact Person) KY \ t') Q,
PPLICANT SIGNATURE .L)(!((~~
k lshOv-e,
Q\rne
(Phone) CjS2 4?'10 ~4~5
(Address)
l?Vy61 g
APPLICANT _I \ n
(N ame) "ttr
(Address) 31010
(Phone)
EaqC\ VI
J (City)
(Phone)
~51
651 315 13LtO
t5:>l2 ~
( Zip Code)
bkS 134 0
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DATE
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain Water Softner
Lavatory (Bathroom S~nk) Stand Pipe (Washing Machine)
Laundry Tray L Sewage Ejector
Shower Stall REQUEST FOR FINA Backflow Assembly
Sinks INSPECTION SENT TO Backflow Assembly Test
Bar Sink MEOWNER 10-06 Lawn Sprinkler
Water Closet ( HO 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 $ 200..00
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit # . ,,;:;. (..;230
'3'1. sa
.50
40.0u
$
$
$
(Office {Jse Only)
Building Official
Date
Paid .
1-'(j. tJo
Date. , _
4-,4-'-()!.:;
Receipt No. "I-ff; JS-
By
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This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714 .fO, DD t+Q
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS I C; I () ~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
I
(\11-L J)
DATE TIME
SCHEDULED ~
)-J l~\{~Qf)~
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CONTR.
PERMIT NO.
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o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
~GC5~~
u'5{-3&~ -l340
- '-
~.(f
~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRE7f)ff::. CALL FOR REINSPECTION BEFORE COVERING
Inspector:"~ t.J _ Owner/Contr:
CALL 44-7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEAL TH & SAFETY!
INSNOTI