HomeMy WebLinkAboutPlg Permit 02-0629
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'l
(Please tvDe or orint and silU1 at bottom)
ADDRESS
'l~ 5d &.urv 00-'( ~
I. Blue File
2. Gold City
3. YeUow Applicant
I PERMIT NOc:?~ - ~~9
ZONING (office use)
RI
LEGAL DESCRIPTION (office use only) (
LOT I BLOCK 1/ ADDITION D~
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PID~-::i7O- 03?-O
OWNER
(Name)
Kusi- ~~Oh
~
. (Phone) qOd - g &d - Lllq I
PV\ oy Lcu<<..
. (Address)
(Phone) l, I;) ,- 8"0 \ ..- 6d.1, 0
C~ rVuJ 6635D
(Address) (City) (Zip Code)
(Contact Person) t:) ~ . (Phone) ~
APPLICANT SIGNATURE \,-"J _ ~_~____,~ -- DATE
APPLICANT PL~OMPLETE BELOW
Type of Fixture I Quantity
Bath Tub with or without shower I
Dishwasher I
I Floor Drain I
I Lavatory (Bathroom Sink) I
I Laundry Tray (lor 2 compartment sink I
I Shower Stall,
I Sinks I
I Bar Sink I
I Water Closet (Toilet) I
APPLICANT A -Il l'^- lA (!
(Name) n ~ u' ~
(Address) ~"ll d
Quantity
Type of Fixture
~
Rough-ins
Water Heater
I Water Softner
I Stand Pipe (Washing Machine)
I Sewage Ejector
I Backflow Assembly
I Backflow Assembly Test
I Lawn Sprinkler
I Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
(Office Use Only)
This Application Becomes Your Building Permit When Approved
f LlD!9
Estimated Cost $ I Building Permit #
PLUMBING PERMIT FEE $ ~ ~ s~
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $" I.{ 0 oe/
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Building Official
Date
Paid 1./ tJ . ce
Dat5"- - 31 -oa-.
- ReceiPl.{~1 / rt
By .
~
V
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
-:.,. Crrv-"'OF PRIOR LAKE
INSPECTION NonCE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
~
DATE TIllE
SCHEDULED
q -gvt!J
l'7UJ-
(1cJ/".' cr,/c LAve-
CONTR.
1- -'2 cr
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W?t::.3ALL FOR REINSPECTION BEFORE COVERING
Inspector: V V r q.... <6 ;((> Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &. SAFETY!
UfSNOTI