HomeMy WebLinkAboutPLMBG 06-0275
THIS FILE 1fAs BEEN
CLOSED DUE TO
CITY OF PRIOR INACTIVny 4/18/2008
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 10-06
Date Rec'd
1- . I 7. O~
llue File
:laId City
{ellow Applicant
I PERMIT NO. O(P. (j z 7~ I
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK
ADDITION
PID2~
I~=~~~ ~"3~~ (~~O~-~~
"(Addres~_ 5-_
APPLICANT CULLIGAN WATER CONDITfONING
(Name) S030 CtJll.lAAN WAY (Phone)
MtNNErONKA, MN 55345
(Address) (952) 933 7200
(Address) (City) (Zip Code)
(Contact Person) (Phone)
. PPLICANT SIGNATuR61~n . --L .f -~.("'Y) ~1"'..ll.1 DATE L-f I L.J /0/ f)
X
APPLICANT PLEASE COMPL~T ~'. KELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain I 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
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)
This Application Becomes Your Building Permit When Approved
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.~.9)
.50
4J. CiO
Building Official
Date
Paid 1-0. (.i Ci
Dat~. /7 tit
Receipt NOSI24--3
By
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S,E., Prior Lake, MN 55372-1714