HomeMy WebLinkAboutPlg Permit 04-0752
Date Rec'd
ell Y OF PRIOR LAKE PLUMBING PERl\'Ul
7 zl ()4-
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ADDRESS
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2. Gold City
3. Ye!low Applicant
PERMIT NO.O 4- . 0752.
ADDITI
ZONING (office use)
/C,"Z-
LEGAL DESCR1l" 1101' (office use 0 y)
LOT
BLOCK
I () ,9 xQ..R.flA Md PID z. 5. "37 er. 173. 0
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I OWNER 1-.1
(Name) 31"CCA'1Cl;\" e
(Address)
APPLICANT
(Name)
(Address)
030 CULLIGAN WAY UNING
· ~5345
(952) 933-7200
(Phone)
(City)
(Zip Code)
(Contact Person)
(Phone)
,,--APPLICANT SIGNA Tl rRE
DATE
PPLICANT PLEASE COMPLETE BELOW
Quantity Typ of Fixture Quantity Type of Fixture
Bath Tub with or ithout shower Rough-ins
Dishwa! :her Water Heater
Floor Drain I Water Softner
Lavator:' (Bathroo Sink) Stand Pipe (Washing Machine)
LaundT) Tray (I 0 2 compartment sink Sewage Ejector
Shower IStall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sint I Lawn Sprinkler
Water Closet (Toi t) Other
FEE S\,;ttI.DULE
Industrial, Commercial & ~ 1ulti-family I % of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated (~ost $
Building Permit #
Of-'. ()7SZ-
~<7. >'0
.50
qO~W2
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
~ This Application Beco~es Your B1 Jilding Permit When Approved
Building Official
Date
Paid 41. c:J 0
Dat~. VI. f) If'
Rec~ NO+- 7Ztfl +-
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24 I.our notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN ~S372-1714
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CITY OF ~RIOR LAKE
INSPECTION NOTICE
SCHEDULED
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ADDRESS
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OWNER I
/7SbY
CONTR.
PHONE N ).
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
~EWER HOOKUP
LUMBING FINAL
o MECH FINAL
COMM,NTS:
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o EXIGRADIFILUNG
o . COMPLAINT
o FIREPLACE RI
o FIREPlACE FINAL
o GASLINE AIR TST
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~/WORK:5ATISFACTORY' PROCEED
/ 0 CORR CT ACTION AND PROCEED
I 0 CORR ! CT WOR~. CALL FO EINSPECTION BEFORE COVERING
Inspector: I Owner/Contr:
I I
CAL~ 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
COD~ REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY I
I
INSNOTl