HomeMy WebLinkAboutPlumbing Permit 11-0030 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED /(f (C
ADDRESS 1 F>26,ta
OWNER CONTR.
PHONE NO. PERMIT NO.
❑ FOOTING ❑ PLUMBING RI ❑ EX/GRAD /FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
❑ FINAL ❑ PLUMBING FINAL ❑ GAS E AIR T
❑ SITE INSPECTION ❑ MECH FINAL Sa
COMMENTS:
mit...mmomumr
WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ COR CT - K, CALL FOR REINSPECTION BEFORE COVERING
Inspect r: / Owner /Contr:
CALL -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
e RIO Date Rec'd
9 CITY OF PRIOR LAKE PLUMBING PERMIT
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1. G File
. Yell old Airy l/ PERMIT NO. 003
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3. Yellow Applicant `
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
1 4 L c21 v-y■ 01 \ 5 S 119
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER D ` "A b l
(Name) f c lki nS (Phone) 61 a - 8 5 (5''
(Address) 1 1 4 to \ dw ) r‘AA. L
APPLICANT CULLIGAN WATER CONDITIONING
(Phone)
6030 CULLIGAN NAY
(Address) MINNETONKA, MN 55345
._ (Acld q) 933 -7200 (City) (Zip Code)
(Contact Person) , < x (Phone) 95 a- 9 I a- 7
/l
APPLICANT SIGNATURE DATE I oa - 30 - ( 0
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough -ins
Dishwasher Water Heater
Floor Drain 1 Water Softener
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (1 or 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 $49.50 minimum Residential, New One & Two - Family $149.50
Residential, Additions & Alterations $49.50
;ost $ ,..) 00 . 0 0 Building Permit #
The Minnesota Statutes § 32613.148
"SURCHARGE" has been changed for one PLUMBING PERMIT FEE $ 99 5 0
year effective STATE SURCHARGE $ 5 00 _—Mir
July 1, 2010, until il June 30, 2011.
The minimum surcharge for a "fixed fee" permit TOTAL PERMIT FEE $ 5 L } , 5(3
is 51, beginning July 1.2010
This Application Becomes Your Building Permit When Approved Paid
,54--SD Rect No. ZD 0�
Date B
Building Official Date /, / Z 1 , 1
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 AI
4646 Dakota Street S.E., Prior Lake, Minnesota 55372