HomeMy WebLinkAboutBuilding Permit 09-0863
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CITY OF PRIOR LAKE PLUMBING PERMIT W OCT 2 0 2009 ~
By
L Blue File I PERMIT NO I
i: ~:~w ~~~Iicant '09. D 0" 3
"
ZONING (office use)
w\\J..s lo..~
553i..;l.,
LEGAL DESCRIPTION (office use only)
LOT BLOCK
ADDITION
PID
OWNER
(Name)
G 0.'(" V'i\~ G o..",,&- ~ ok.
~ ~L.b ~'\\j~ Lli..~
(phone) q.s~ '-\Cl3 11 ~
(Address)
APPLICANT
(Name)
CULLIGAN WA TEA CONOll tONrNG
6030 CULLIGAN WAY
't1t~NM. MN 55345
2) 933-7200
(phone)
(Address)
(City)
(Zip Code)
.;
(Contact Person)
(phone)
APPLICANT SIGNATURE
DATE
10 - <6 - O~
Ouantitv Type of Fixture Ouantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain I Water Softener
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (1 or 2 compartment sink Sewage Eiector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
APPLICANT PLEASE COMPLETE BELOW
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. DC), \J '0
Building Permit #
(Office Use Only)
This Application Becomes Your Building Permit When Approved
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
4<1. Sa
.50
5(:). C:lt)
Buildine Official
Date
Paid SCI Aru
Date
t4 .1,.d ,.,u,
O'sYof-'1
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372