HomeMy WebLinkAboutPlg Permit 03-1579
~
s~~
~~~~~.v
I,
l . (Please type orP1int and sign atl_~__)
ADDRESS
S' 87 D C ro~:>f.Y1 d rt.:\
Date Rec'd
CITY p.... DOlOR LAKE PLUMBING PERMIT
:~ I'EKMIT NO. /13 ~ ,J Ii:: I'bc;
ppliClJ\t (/,.., ". I
S1"'37~
ZONING (office use)
se
LEGAL DESCRlr l10N (office use only)
LOT J I BLOCK / ADDITION /4A,rI~/ 12.. /~ / sf"
- u
PID.dS:01 tt!i:.O //- Q
OWNER
(Name)
(Address)
~~ ,.4:> ~'=>cJ.r-c.
(Phone)
APPLICANT
(Name)
(Address)
CUll IGA~ W.4.TER CONOITIONIf.4~
6030 CULLIGAN WAY
MINNETONKA, MN 55~4o
(Ad~) 933-7200
(phone)
(City)
(Zip Code)
(Contact Person)
.... ._APPLICANTSIGNATURE~~",. ...k-~-'
r.~~ , /
I
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain I Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment" . Sewag;e Ejector
S~ower Stall REQUEST FOR FIN ~mbly
Smks IN AL embly Test
Bar Sink SPECTION SENT TO ,r
Water Closet (Toilet) HOMEOWNER 01-06
(Phone)
DATE
/1/75"1 d3
Quantity
Type of Fixture
14J!.J!.S~IU!.DULE
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 $ aOf'J r "CJ
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
-3(ft ~
.50
'-(() r tJCI
(Office Use Only)
.~rThiS Application Becomes Your Building Permit When Approved
--,- \
Building Official
Date
Paid ,.,--
LI~.,
Date /;;}- /0-0
Recevg 8SS
~
V
u
24 hour notice for all inspections (951) 447-9850, fax (951) 447-4145
16100 Eagle Creek Ave., S.E., Prior Lake, MN 55371-1714
v
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
5870 OWSSANDe.4
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH Rf
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
OA TE TIME
Z .I1.0Co
'3 . fS7CJ
I
o EXlGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
S "V0lL
IN~.P~L'11DN' :LEI'TERS otfr-
-RECElVFJLNQRESpONSF
CL98E-FILE--OOE--+Q
INACTIVITY
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.,
IIfSJiOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEAL TH & SAFETY!