HomeMy WebLinkAboutPlg Permit 01-1312
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
~. ~~ ~!;y PERMIT NO. /'J/.....I.;?J~
3, Yellow Applicant V I J{ r I
(Please type or orint and si~ at bottom)
ADDRESS
/5a51 WiLDS 1>~WY
ZONING (office use)
.fJu1J
LEGAL DESCRIPTION (office use only)
LOT J BLOCK I ADDITION !I ) d( tv Lj-tA
OWNER f\ L (\._
(Name) LX\elj~nf, LK\5~
(Address) L./"' ~~ AS. ~_<-------
PID ;;).~ ~ ~ L/ tI- (}CJ lit)
(Phone(~ do,to 5lQ 3,51)
F>'5~ I ~
APPLICANT CULLIGAN WATER CONDITIONING
(Name) 0030 OULLlGAN WA'!
MINNETONKA, MN 55345
(~cPc6~s~33. 7200
(Phone)
(Address)
(City)
(Zip Code)
(Contact Person) (Phone)
. APPLICANT SIGNAT~~~ DATE
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)
lO\2.G \("'1 \
Quantity
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
Estimated Cost $
Building Permit #
Building Official
Date
.:='>9. ~()
j .50
LtO ~ C'Jl) .
paid1PLf 0,00
Date
11""/&:'-0 }
Receipt NCfrYl, {? , '
By ff6V
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
....
..
DATE TIME
/z/7hl
, ,
L/:~
ADDRESS
/50>- z;? ~ ~
;-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MEcH RI
o FRAMING 0 WATER HOOKUP
it1INSULA TION 0 SEWER HOOKUP
I)r FINAL 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS: ~ ~
f
()~
V.()~ It _ e,
tJl-/3/Z,
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
./
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o cORRE? c\LL FOR REINSPECTION BEFORE COVERING
Inspector:' ~ - v tl.v..IJ Owner/Contr:
CALL ~7-9850 FOR THrfNEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS~RE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl