HomeMy WebLinkAboutPlg Permit 04-0751
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
7- 1,1.04-
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ADDRESS
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REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 01-05
File
City
Applicant
PERMIT NO. tJ4- .015/
. ZONING (office use)
Ie I S..D
LEGAL DESCRIPTION (office use only)
LOT 13 BLOCK I ADDITION Otcl /ali ND l5E;7tc.t-l 4 m
PID z..S /38. 0/.5.0
OWNER
(Name)
(Address)
Tv
,
L/J.r..s~
(Phone)
I APPLICANT
(Name)
(Address)
CULLIGAN WATER CONDITIONING
6030 CULLIGAN WfI,.V
(MlNNETONKA, MN 55345
(952) 933..7200
(Contact Person)
APPLICANT SIGNATURE .~4'~
(Phone)
(City)
(Zip Code)
(Phone)
DATE
7!t.,loy
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
I Floor Drain I Water Softner
I Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
I Bar Sink Lawn Sprinkler
I Water Closet (Toilet) 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 $ 2.Qj, ~
Building Permit # 04-. 0 75 J
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
'37. ro
.50
'10(0,,)
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
paid...l..-c:
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Date c) 4-'
7. 'Z-/.
ReceiP~ N~1z... '14-
By (.
o
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
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~ /
CONTR.
OWNER
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
~UMBING FINAL
o MECH FINAL
COMMENTS: I /
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DATE
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TIME
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o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
YWORK SATISFACTORY, PROCEED
I ci" CORRECT ACTION AND PROCEED
o CORRECT WO}~~K:J*~FOR REINSPECTION BEFORE COVERING
Inspector: .'~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
1N$/iOTI
CODE REQUIREMENTS A.RE FOR YOUR PERSONAL HEALTH &: SAFETY!