HomeMy WebLinkAboutPlg Permit 04-0523
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
(p./~04-
(Please type or print and si~ at bottom)
ADDRESS
37t35 .f1:n<~,L ~t<-
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 01-05
'e
Iy
Iplicant
PERMITNO.O~. oS? ~
ZONING (offic:euse)
J1Jw
I LEGAL DESCIUr iiON (office use only) 6-
LOT 3S BLOCK I ADDmON (J) . .eA\.DMCt./Wv\... Q. \J
PID z5. 3S5. 035.0
OWNER
(Name)
(Address)
c~ r~:) '16 MA .5
(phone)
APPLICANT
(Name)
CULLIGAN WATER CONOITIONING
A'~~Q CULLIOAN W"",' (phone)
MINNETONKA, MN 55345
(Address) ,tS2) 833., ~uu (City)
(Zip Code)
(Address)
(Contact Person)
(phone)
---
PPLICANT SIGNATURE
DATE
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
I Floor Drain I Water Softner
I Lavatory (Bathroom Sink)- Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 compartment sink I Sewage Ejector
I Shower Sta' I Backflow Assembly
I Sinks REQUEST FOR fINAL I Backflow Assembly Test
j Bar Sink INSPECTION SENT TO I Lawn Sprinkler
I Water Clos HOMEOWNER 01-06 I Other
I' .r...r.. ~'-- D.r..V U LE
Industrial. Commercial & Multi-family 1% of job cost with a $39.50 minimum
Residential. New One & Two-Family S99.50
Residential. Additions & Alterations $39.50
Estimated Cost $
~oO~
Building Pennit # 0 ttF. 052.3
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
'3 '7. j"'O
.50
'10, c).J
,~ffice t.:se Only)
'his Application Becomes Your Building Permit When Approved
Building Official
Date
Paid-l-(}. Q ()
Date lj. 2 . 0 4-
Receipt NO~~9'8
BYfD'
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, :\IN 55372-1714
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS 31125 ~)t" -k,t 1";.
OWNER CONTR.
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
(
Q~~
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
j~
T ) I
-rt'-l--t.
DATE nME
J~
q-'5~)
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE A!R I~T
J(JJe.t.~ ~
~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRE ORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
../
.'-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOn