HomeMy WebLinkAboutPlumbing Permit #03-1149
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
17J35
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE nMe
SCHEDULED
1-/7
12'-t-/ A._,t..
CONTR.
PERMIT NO.
5-flt.{~
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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(l L"llJ)
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~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~<;rK, ~L FOR REINsPECTION BEFORE COVERING
Inspector: , vr' q -17....~ner(COnlr:
CALL 447-9850 FOR THE NEXT INSPECTION '.4 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
f3 . -z8.o3
: ~~: ~::y I PERMIT NO. OY-I' I A/?_ I
J, Yellow Applicant I ,.,..7
(Please '!ype or print and sign at bottom)
. ADDRESS
I ~'lJ?Jc) ./<' if/I/birch ~ L <: E
ZONING (office use)
LEGAL DESCRIPTION (office use only)
BLOCK
ADDITION
PID75 37'1. /3t,. J
LOT
OWNER A /I A J . I2r1:.. '
(Name) ----I--V-K4--J<< tJ. j ! J 9 ~r, (Phone) 9S;J-4 l/ 7 lj. C- L{j
(Address) 171Jh,\ ,(iw fb/rch ~ ,(E
. .
APPLICANT
(Name)
(Address)
CULLIGAN WATER CuNUlIIUNINl:i
~O GLJI.L1GAN WAY
MINNETONKA. MN 55345
~J:;?) Q~~~no
(Address)
(Phone)
(City)
(Zip Code)
(Phone)
;ffkUlm_.: DATE
(Contacr Person) 0l
,-\PPLICANT SIGNATURE. \ tf7)flIL
Quantity
g-/j-tJ6
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Balh Tub wilh or wilhout shower
Dishwasher
Floor Drain
Lavatory (Balhroom Sink)
Laundry Tray (I or 2 comparimenl sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
Type of Fixture
I
Rough-ins
Waler Heater
Water Softner
Sland Pipe (Washing Machine)
Sewage Ejeclor
Backflow Assembly
Backflow Assembly Tesl
Lawn Sprinkler
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 $ ~t'J 4iSZ-
Building Permit # IJ~ -//4--9
'-- ;SCJ. stY
_ .50
qlJ ~ 00
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
(Office Use Only)
.1 This Applicalion Becomes Yonr Bnilding Permit When Approved
Building Official
Date
paid.ft? f./l)
. Date~.UI. OJ
Rec1~z;r 7
By 4JI!.--
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714