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HomeMy WebLinkAboutPLMBG 06-0153 TlIIS FILE lfA ('T""" ow PDTOD T .J\. KF. IN~~SED Dui ~~N REQUEST FOR FINA~ TVrry 4/18/2008 INSPECTION SENT TO HOMEOWNER 10-06 Date Rec'd I. Blu. Fil. 2. Gold City J . Yellow Applicant I PERMIT ~\I. Oto ~ IS 31 ZONING (office use) LEGAL DESCRIPTION (office use only) LOT '0 BLOCK J ADDITION mrn Blvd (\)E f::x::j::n~ 1m J- iJ<1 OWNE~ (Name) ~ Fvo..ns (Address) Pro) 5 - -D APPLICANT (Name) (Address) CULLIGAN WATER CONDITIONiNG 6030 CULLIGAN WAY MINNETONKA, MN 55345 (Addr'Qq2) 933~ I::!UO (Phone) (Contact Person) (City) (Phone) (Zip Code) .. .. PPLICANT SIGNA TV DATE c.Y/r:;)~/0( 0 Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough-ins Dishwasher Water Heater Floor Drain J Water Softner Lavatory (Bathroom Sink) Stand Pipe (Washing Machine) Laundry Tray (lor 2 compartment sink Sewage Ejector Shower Stall Backflow Assembly Sinks Backflow Assembly Test Bar Sink Lawn Sprinkler Water Closet (Toilet) Other APPLICANT PLEASE COMPL BELOW 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 # (Office Use Only) PLUMBING PERMIT FEE $ STATE SURCHARGE $ TOTAL PERMIT FEE $ .3=1.f5() .50 4{).OD This Application Becomes Your Building Permit When Approved L \ Building Official Date 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4 5 16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714