HomeMy WebLinkAboutPlg Permit 05-0130
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
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1, . t<o . 0 '::.
(Please type or print and sign at bottom)
ADDRESS
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I. Blue File PERMIT NO
2. Gold City . Ole-. 0/30
3_ Yellow Applicant '.;;;J
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ZONING (office use)
LOT
LEGAL DESCRIPTION (office use only)
ADDITION
BLOCK
OWNERo... I
(Name) 1.- ~ lA.b.' '::)V L.AUf:..
. (Address) ~ n~ A~
(Contact Person) (Phone)
'PPLlCANTSIGNATu61~ry,\--t-)~. DATE ~
APPLICANT PLEASE COMPLE~ELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (1 or 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
APPLICANT
(Name)
(Address)
Quantity
CULLIGAN WATER COf\lf1tTIONING
6030 CULLIGAN WAY
~\ON. KAt M~! €i~14l3
2) 933-7200
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
Estimated Cost &n .C50
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(Phone)
(City)
(Zip Code)
Type of Fixture
I
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
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.50
Ly)CJ::)
Paid
Receipt No. 4f; g () I
By pL-
An.OO
Date-Z /1 e .;0 b
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
DATE TIllE
CITY OF PRIOR LAKE ~
INSPECTION NOTICE SCHEDULED
(hJ4~ (j)Jh
ADDRESS ;;J7 / f5
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OWNER CONTR.
PHONE NO. PERMIT NO. 5'-0/30
o FOOTING o PLUMBING RI o EXIGRADIFILLING
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 jG~A~
o SITE INSPECTION o MECH FINAL
COMMENTS:
~
~RK SATISFACTORY, PROCEED
o CORRECT AC ON AND PROCEED
K, CALL FOR REINSPECTION BEFORE COVERING
Owner/Contr:
C ~98~OR THF NEXT INSPECTION 24 HOURS IN ADVANCE.
~REM~~TS:RE FORY~UR PERSONAL HEALTH & SAFETY!
IN$NOTl