HomeMy WebLinkAboutPlumbing Permit #03-0996
Date Rec'd
CITY OF PRIOR LAI(E PLUMBING PERMIT
REQUEST FOR FINAL
INSPECTION SENT T()
HOMEOWNER 1/04
1. Blue File
2. Gold City
1 Yellow Applicant
PERMIT NO. 0 3 -9?a:,
(Please type or print and sign. at bol
, ADDRESS
113B3 (junyt{14 ~uttu ~W.
..J
LEGAL DESCRIPTION (office use only)
LO-r3> BLOCK S ADDITION
ZONING (office use)
(Address)
I J Joodu,' OU {E+-.
ot?Wid ~ 1J(1Ei>Y\
- ~f\IU..., tiS tLbv~--
CtJLllGAN' WATER CONDITIONINO
6030 CULLIGAN WAY (Phone)
MINNt: I uN~A, MN 55345
(952) 933..7200 .....
PID075"~30- CJ/~r-o
OWNER
(N ame)
(Phone) q'5-z,-l~ 1.-71
APPLICANT
(Name)
(Address)
(Address)
(City)
( Zip Code)
"PLICANT SIGNATURE
A /7
>LJ--u I~^-Jl
(Phone)
(Contact Person)
DATE
(, -27 ,-&3
Quantity
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
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)
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
FEE SCIIEDULE
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 $ '/1)0 .-/
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERlVlll FE:E $
~.50
.50
AD.ro
(Office Use Only)
Date
It /
'-1,~ I
1.r(1r3
Receipt NL;..!JJ11
By r
"'his Application Becomes Your Building Permit When Approved
Paid
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E.,. Prior Lake, MN 55372-1714
OA TE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
'?-~ -de!
ADDRESS
/738>
S0?1 "'.~f C ( :.-
OWNER
CON"I"R.
PHONE NO.
PERMIT NO.
?- ?/(t
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
/-f ~O 5'~ -r
~.- -=------
(/ / r::A - 1::;/ n')
l ,.A U(.;L.- ( ,- /
'" ~
----- ------
~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W,~";~FOR REINSPECTION BEFORE COVERING
Inspector: r V f "'" Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY/
lNSJ'IOTl