HomeMy WebLinkAboutPlg Permit 03-0628
/
Date Rec'd
r'.",.,'
CITY OF PRIOR LAKE PLUMBING PERMIT
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 6/03
~:~ PERMIT NOo() ~ /' /./ 1'"'\ (}r
w Applicant J (~
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(~7Z)
ZONING (ofticeuse)
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(Please type or print and silO! at : . ;;.. ,.J)
. ADDRESS
3/8q Lintkn dtOrtLe./
LEGAL DESCRtr l.lON (oftice use only)
LOT 8JLOCK ADDITION /) rii1Ju) 'Y)() L
(Address)
Lf!SJ )"u lv/A fA d.3 fell
(<);1 f11--f, A<;' dbtJYC ')
PI~5- ) Lj /-() 301:)
(phone) q?2-441- 47&1
OWNER
(Name)
APPUCANT
(Name)
CULLIGAN WATER CONDITIONING
~03g CUlL.IOAN WK( (phone)
MINNErONKA, MN 55345
(Address) ,852) 833.. f ~UO (City)
(Zip Code)
(Address)
(Contact Person)
/1
vJ~'&~A-fl
(phone)
r--APPLICANT SIGNATURE
DATE
-5 - (p -.43
Quantity
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
Type of Fixture
REQUEST FOR FINAL
INSPECTION SENT TO
Industt.~()MEOWNER 8/19/03
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
h a $39.50 minimum
Residential. New One & Two-Family
Residential. Additions & Alterations
$99.50
$39.50
Estimated Cost $ 20D --
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
315Q
.50
41). Of)
(Office Use Only)
f~:rhis Application Becomes Your Building Permit When Approved
Building Official
Dale
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Dab-'__d7-o3
Receigt No...<'~
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24 hour notice ror all inspections (952) 447-9850, rax (952) 447-4245
16200 Eagle Creek A,'e., S.E., Prior Lake, :\IN 55372-1714
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 2. ./7J.) C;,
ADDRESS 318'1 ~ I AlOt;,7V ('4 rc..
OWNER CONTR.
PHONE NO. PERMIT NO. 3. ~zr'
o FOOTING o PLUMBING RI o EXIGRADIFILLlNG
o FOUNDATION o MECH Rl o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULA TJON o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL o GAS LINE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS:
-8ENf TWO REQ-UES~ FQR-
TNSPF,CTIQN LE.IJ'Ji:KS UlJl'
seoNSE.
€b6SE _ Te
IN_~rTIVITY
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, 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!
...
I/fSNOT1