HomeMy WebLinkAboutPLUMBING 05-1172
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Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
REQUEST FOR FINAL
INSPECTION SENT TO
(Pkuo~''''';:;_; _ HOMEOWNER 10-06
[ADDRESS
'W.3:::f-~ - 'V haw\C.D ALe. SE
~~~ I PERMIT NOS. / /12-
Applicant .
'dO~1
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID Z5 . Z;1~. OGq ))
r
I OWNER
(Name)-=r&'fY") ~n
. (AddreSS)~ A~Jf'
(~J~o-~
APPLICANT
(Name)
CULLIGAN WATEf1 CONDITIONING
6030 CULLIGAN WAY
MINNETONKA. MN 55345
(Address~~02) 933-7200
(Phone)
(Address)
(City)
(Zip Code)
(Contact Person)
APPLICANT PLEASE COMPL
Quantity Type of Fixture Quanti
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
DATE \ \ I LfJ 1CF5
'PPLICANT SIGNAT
ELOW
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
Estimated Cost $ c~<;50
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
31.~
.50
~O.()O
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid 41J -
Dat71. 2f. {,s
)]99
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714