HomeMy WebLinkAboutPlumbing Permit 04-0391
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Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
6. s-. 0 If'
I. 8M File PEnll. NO
2. Gold City n.!Ylll. /'fA. 0 '7/? I
J. Yellow Applicant (R"" ~ .,
(Please l'YDe or 1Jrint and sip at bottom)
ADDRESS
ZONING (office use)
q~o7
o..>>-r L ~ K <JY'.
LEGAL DESCRu- liON (office use only)
LOT BLOCK
ADDIII0N
PID 2~. z-q~. o(p 7.0
OWNER J ,-
(Name) J-C2t1n".Q.v 611[~cv\
(Address)
(phone)
Ax r 1JCANT
(Name)
CULJ.IGAN WATER CONDITIONING
.O~O CULLIOAN WAY (phone)
MtNNETONKA, MN 55345
(Address) {'52) 833.Y20u (City)
(Zip Code)
(AdcLOooh))
(Contact Person)
r' l>>PLlCANT SIGNATURE
(phone)
DATE
APPLICANT PLEASE COMPLEI~ BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain I Water Softner
l Lavatory (Bathroom Sink) I Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 compa. Lment sink l Sewage Ejector
I Shower Stall I Backflow Assembly
I Sinks I Backflow Assembly Test
I Bar Sink I Lawn Sprinkler
I Water Closet (Toilet) I 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 $
Building Permit # O~" 639/
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PEAA111 FEE
~mcc Use Only)
, 'his Application Becomes Your Building Permit When Appro\'ed
$ 3~ rv
$ .50
$ l..{tJc.o..J
Building Official
Date
pai~. (J 0
Dat~. 5.01-
ReceiptNo.~90~
BY~
24 hour notice for aU inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek A\'e" ~.E., Prior Lake, :\fN 55372-1714
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
LiC07 ~6dL
OWNER
CONTR.
PHONE NO.
PERMIT NO.
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
COMMENTS:
DATE nue
S - ''''If-fA,{
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4~~CC(
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
[] CORRE~~ 7/~LL FOR REINSPECTlON BEFORE COVERING
Inspector: V Owner/Contr:
CALL 447-9850 FOR THE N~XT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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