HomeMy WebLinkAboutPlg Permit 05-1141
CITY OF PRIOR LAKE PLUMBING PERMII
Date Rec'd
11.15.0~
~. ~~ ~:~ PERMIT NO. 0 '5. 114- ,
3 . Yellow Applicant
(Please type or Drint and si2ll at Lv.~"~)
ADDRESS ZONING (office use)
IS 59 X'
(jrc..k~
5537:J
C\( J e..
LOT
LEGAL DESCRIPTION (office use only)
ADDITION
(Contact Person) (Phone)
PPLICANTSIGNATU~(Y)~ DATE llLaJt"R
APPLICANT PLEASE COMPL(:i 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)
OWNER
(Name)
. (Address)
APPLICANT
(Name)
(Address)
Quantity
BLOCK
PID zs-. 4-17. (jDft,.D
c.~~d<.
5 Ck.YY\'?
Me tQ II
(Phone) qSd - \.flfO - '15'19
C\.5 o..bc\J e...
CULLIGAN WATER CONDITIONING
5030 CULLIGAN Wt.Y
MINNETONKA, MN 55345
(Address~g~2) EJ3.1200
(Phone)
(City)
(Zip Code)
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 $ dODo DU
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
J't, SO
.50
LlO,DO
_ jOffice Use Only)
fhis Application Becomes Your Building Permit When Approved
Building Official
Paid 40 _
Date//J(,.()S'
Receipt No. 57)3 8J
Bi-;
U
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
DATE TillE
CITY OF PRIOR LAKE ll.~
INSPECTION NOTICE SCHEDULED
ADDRESS 1'5~t:t 8 'fJt1:O ~.A
OWNER CONTR.
PHONE NO. PERMIT NO. c;- - /Ill,!
o FOOTING o PLUMBING RI o EXIGRADIFILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL X~:t;A~~
o SITE INSPECTION o MECH FINAL
COMMENTS:
$'WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED .
o CORR~.~ RK, CALL FOR REINSPECTION BEFORE COVERING
InSpector\ ~ \~ / . Owner/Contr:
CALL 44 850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
.-i
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .I SAFETY!