HomeMy WebLinkAboutPlumbing Permit 09-0136
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS . l7CfA(o
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED ~~
Qr\\A~
~
CONTR.
PERMIT NO. 1 - {3V
o PLUMBING RI 0 EXIGRAD/FILLlNG
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
g.. PLUMBING FINAL 0 GAS LINE AIR TST
o MECH FINAL 0
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!WORKSATISFACTORY, PROCEED
o CORRECl\ACTION AND PROCEED
o CORRdT-WORK, CALL FOR REINSPECTION BEFORE COVERING
J
447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
Owner/Contr:
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
L Blue
2. Gold
3. Yellow
4,6,0;
PERMIT NO.Oq, 0/3to I
(Please type or print and si~n at bottom)
ADDRESS
, f"{ '-l g 10 -5 u-V\ r C~ \.I
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File
City
Applicant
ZONING (office use)
C, ( Lie
,5'537,)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
S h G\ l,J v -. Ft I; p e k
J ''I Li g L .S- 0- V, ( (Av-, C 1'"( Lt
I
(Phone)
C}s.) -l.fL/O. 5559
(Address)
APPLICANT
(Name) CULLIGAN WATER CONOITIONIN8
6030 CULLIGAN WAY
(Address) MiNNETnN!< A, ~_1f\j z52~S
(~~seb3- 7200
(Phone)
(City)
(Zip Code)
(Contact Person)
.~U~
(Phone)
APPLICANT SIGNATURE
DATE
3-db-0<1
-----,.
.-----.1
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
I Dishwasher Water Heater
I Floor Drain I Water Softener
I Lavatory (Bathroom Sink) I Stand Pipe (Washing Machine)
I Laundry Tray (1 or 2 compartment sink I Sewage Eiector
I Shower Stall I Backflow Assembly
Sinks I Backflow Assembly Test
Bar Sink I Lawn Sprinkler
I Water Closet (Toilet) I Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $49.50 minimum Residential, New One & Two-Family $149.50
Residential, Additions & Alterations $49.50
Estimated Cost $ --.d ij 0 , 0 0
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
Yc; I 50
.50
c; 0.0 n
(Office Use Only)
Buildin!!: Official
Paid SO, 0 ()
Date A CI
~~ ~. ~(a/
24 hour notice for all inspections (952) 447-9850, fax (952) 4474245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
Recei~No. 57707
BY1. .
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This Application Becomes Your Building Permit When Approved