HomeMy WebLinkAboutPlumbing Permit #04-0431
DATE TIME
CITY OF PRIOR LAKE (p.cr-ofj
INSPECTION NOTICE SCHEDULED
ADDRESS :!/'pCCI I e,,>C -ra.-J
OWNER CONTR.
PHONE NO. PERMIT NO. L( - L{ > (
o FOOTING o PLUMBING RI o EXIGRAD/FILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL ~Gt~I~A~~
o SITE INSPECTION o MECH FINAL
COMMENTS:
~K SATISFACTORY. PROCEED
o CORRECT TION AND PROCEED
o CORRE ORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector~ Owner/Contr:
C fJ;;;,~OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
COD ~REMENTS ARE FOR YOUR PERSONAL HEALTH &; SAFETY!
INSNOTl
1\~ @ ~ G~~'d
CITY OF PRIOR LAKE PLUMBING PERMt~ ,~ 11\\
f-, MAY 1 S 2004 ~
I. Blue File PEl&.l ~6.,()4'-.J&'()4' 3/"--,
2 Gold City
J Yellow Applicant
(Please type or print and si~ at bottom)
ADDRESS
-3f.t;17 fO^~(L ~(L
ZONING (office use)
LEGAL DESCRlr lION (office use only) d
LOT;)~BLOCK (ADDmON I1J ~1Ib~ Q M
PIDzE": 385. fJ2lJ.O
OWNER
(Name) l~ 4-n:.;f (l0 j )..e I (
(phone)
(Address)
APPLICANT
(Name)
CULLIGAN WATER CONOITIONING
i03Q CULLIGAN WAY (phone)
MINNETONKA, MN 55345
(Address) (952) 9~3..12(iu (City)
(Zip Code)
(Address)
(Contact Person)
(phone)
PPLICANT SIGNATURE
DATE
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture I Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain I Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 compa. Llllent sink Sewage Ejector
I Shower Stall Backtlow Assembly
I Sinks I Backflow Assembly Test
I Bar S ink I Lawn Sprinkler
I Water Closet (Toilet) I Other
FEE SCHEDULE
Industrial. Commercial & Multi-family 10/0 of job cost with a $39.50 minimum Residential. New One & Two-Family $99.50
Residential. Additions & Alterations $39.50
Estimated Cost $ dOO, 0"
Building Permit # tJ~ tF4- yo
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERl\'u 1 FEE $
'~7. ~
.50
40(oJ
-..l/)mc~ Use Only)
Building Official
Dat~
Paid 4<J ,00
Date - I'? 0 ti-
.::>. ..J,
Receipt NO# 9 z,5
IJ
BY!
()
,"his Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, ~fN 55372-1714