HomeMy WebLinkAboutPLUMBING PERMIT 16-945 j( DATEE TINE
Y F PRIOR LAKE SCHEDULED � _'
INSPECTION NOTICE
ADDRESS t e �\
OWNER CONTR.
PHONE NO. PERMIT NO. k(P (14
❑ FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
❑ FOUNDATION 0 MECH RI 0 COMPLAINT
❑ FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
❑ INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
❑ FINAL 0 PLUMBING FINAL �❑ GASLINE AIR TST
❑ SITE INSPECTION 0 MECH FINAL `}I
l.
Z Silt-
COMMENTS:
WORK SATISFACTORY,PROCEED
CORRECT ACTION AND PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
0(91-44---)
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTI
_ _
4V RIODate Rec'd
E011
CITY OF PRIOR LAKE PLUMBING PERMIT
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�SO�SIBlue File
z.,�w �;ry PERMIT NO. / J(146i"
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
its\\\ LakIs R' - SA. SE. 553'7c),
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) �-'c A \1._e-,\C 2� \O \ (Phone) '9 S a DQ l 91A9
(Address)
APPLICANT
(Name) 4ULLIGAN WATER CONDITIONING (Phone)
6030 CULLIGAN WAY
(Address) MINNETONKA, MN 55345
(Address(952) 933-7200 (City) (Zip Code)
(Contact Person) (Phone)
APPLICANT SIGNATURE 6, 2 7 DATE t"' I I(n
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 t Water Softener
Lavatory(Bathroom Sink) Stand Pipe(Washinj 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
Estimated Cost $ cp pp,(DO Building Permit#
PLUMBING PERMIT FEE $ 44 --c®
STATE SURCHARGE $ /•60
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid /�1 d 6-0
Recei t No. j / /jam
Dateg'
l(L I; By q
Building Official Date '
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372