HomeMy WebLinkAboutPlg Permit 05-0157
CITY OF PRIOR LAKE PLUMBING PERMIt
Date Rec'd
3,/,05
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
(Please type or print and si2ll at bottom)
ADDRESS
(lJO?7l
f'-.orfVlwood
~( ~ VY
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER 1\ A (I CIl I'
(Name)~
(Address) 110 () h 1
J U1uJJ6 4- ~
~~fthw~Od ~d N Vv'
APPLICANT
(Name)
CULLIGAN Vv:ATER CONDITIONING
ou,",u I",iULLluAN WAY
MINNEtONKA. MN 55345
(Addr&ij)2) 933-7200
(Contact Person) Ar-ttitl~ tl () I W /\. II
\PPLICANTSIGNATURE ~~ -JLIILVl.
(Address)
Quantity
I. Blue File I PERMIT NO I
2 Gold City '05. 0/57
3 . Yellow Applicant
ZONING (office use)
PID.z.5: /4-1. 07'1. 0
(Phone) (qFiJ)44/) - 45q~
(Phone)
(City) (Zip Code)
(Phone) Cf h"J- .. Cf I ;r.llJt 0
DA~ d / J I / a()Off
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
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
Building Permit # OS. () /57
,?A.50
.50
40..OQ
Estimated Cost $ -2f]O gg
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
$
$
$
Paid fO.O 0
Date 3. J. 0 ~
Receipt NO~BZ,/
BY~
/
24 hOUT notice fOT all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
ADDRESS
/ ~Qlf;
=i<-~
~Qq
TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
PHONE NO.
CONTR.
PERMIT NO. 5 - J S- 7
OWNER
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI 0 EXIGRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
~o SEWER HOOKUPL. ~ ,.~ 0 FIREPLACE FINAL
, PLUMBING FINAsr-/iG ~IR TST
~/' MECH FINAL 1./ ~..
COMMENTS:
u oCL ~~('- ~~
~
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT LL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CAL L 850 R THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE R~NTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl