HomeMy WebLinkAboutPlg Permit 01-1389
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CITY OF PRIOR LAKE PLUMBING PERMIT 12-.-1 - 01
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PERMIT NO.
Date Rec'd
(Please tvve or urint and sie:n at bottom.)
L Blue File
2, Gold City
3, Yellow Applicant
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ADDRESS
'1 aLi/1 '~+;-eJd h. Sf,
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LEGAL DESCRIPTION (office use only)
OWNER
(Name)
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~~AS
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PID 25 -372- - () '-18-(, I
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LOT
BLOCK
ADDITION
(Address)
APPLICANT
(Name)
CULLIGAN WATER CONDITIUNING
r.03O-C11I I IGAN WAY
MINNETONKA, MN 55345
'~2) 933-7200
(R dress'
(Phone)
(Address)
(City)
(Zip Code)
(Contact Person)
~~
(Phone)
APPLICANT SIGNAT R
DATE
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Quantity
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APPLICANT PLEASE COMPLETE BELOW
I Type of Fixture I . Quantity
I Bath Tub with or without shower I
I Dishwasher I
I Floor Drain I
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
I Water Closet (Toilet)
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
REQUEST FOR INSPECTION
SENT TO CONTRACTOR. NO
RESPONSE - CLOSE FILE
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 $ JC'{) cl). Building Permit # () 1- /38q
.
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$~.5J
$. ,50
$ 4f' '()(l_
(Office Use Only)
Your Building Permit When Approved
12-.;/1-0 I
Date
Pai~. 00
Da}i,/II_ 0'
Receipt ~ q tq 4-
BYjIJ-
24 hour notice for aU inspections (952) 447-9850, fax (952) 447-4245