HomeMy WebLinkAboutPlg Permit 01-0847
Date Rec'd
CITY.OF PRIOR LAKE PLUMBING PEAAul
,"
(Please tvoe or orint and sign at bu....~)
ADDRESS
~ ~~ C-+-
L Blue File PERMIT NO
2, Gold City . A") 1_
3. Yenow Applicant (../
C37Ql)
LEGAL DESCRIPTION (office use only)
LOT I/) BLOCK I ADDITION k~ .JJtlt ~
PID~:~- O/()-(I
OWNER,^^ L .
(Name) '1 \~ OJ. Y"\ ,
(Address) 5nllYU
APPLICANT
(Name)
vY\C\Ak
(Phone) 9.5J 14fr3 -lrJ-/;)1
(Address)
CULLIGAN WATER CONDITIONI~one)
6030 CULLIGAN WAY
~INNETONKA. MN 55345
(Address) (952) 933-7200 (City)
(Zip Code)
(Contact Person) "'-
APPLICANT SIGNATURE\J~~'.<
Quantity
(Phone)
-i1^Al~
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)
DATE
7 jt3 .JI)I
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 $ r9LJDstL
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$ _~q<20
$ - . F. .50
$ /..In ~
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid '10,00
Date~~g -0 I
ReceiPLfo33 7
BY~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
\
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDJ.1-ED
DATE TIME
2- "'{,'O ~ 3: j..-l)
ADDRESS
./ 42..88 ' /:)() (,/6 C!A
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING @ 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
Q1FINAL 0 PLUMBING FINAL
/B'SITE INSPECTI 0 MECH FINAL
COMMENTS: .~.. . \.
~~
/ - ! 4-7
,
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
)t -1:t.? o..s Off .
>t WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR~K CALL FOR REINSPECTION BEFORE COVERING
~
Inspector: . Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!