HomeMy WebLinkAboutPlg Permit 05-1142
CITY OF PRIOR LAKE PLUMBING PEAAuI
Date Rec'd
". ,5,05'
I. Blue File PERMIT NO
i ~~~w ~~~ticant . 0,". 114- Z
(Please type or orint and sign at bottom)
ADDRESS ZONING (office use)
110 do crq
Po..f"" k \/ i e uJ
ti, V e.
...553 7 ~
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID 25.31(0. OIZ.O
OWNER
(Name) kiv\ V'\ c; rY\a.ry
(Address) ~~L ns
~h"'5-\-OY)
o..ht>ve..
(Phone) 95;;)- l{l.\ 1- b;;lb <1
(Address)
CULliGAN WATER CONO\TIONINU
5030 CULLIGAN WAY (Phone)
MINNETONKA. MN 55345
{S(2) 933 720n
(Address) (City)
(Zip Code)
APPLICANT
(Name)
(Contact Person) (Phone)
PPLICANTSIGNATU~~ (Y)~ DATE ilftYI(A
APPLICANT PLEASE COMPLE~ELOW
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)
Quantity
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 $ d tl 0 ' () ()
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
3~.50
.50
'-10, {) D
jOffice Use Only)
'his Application Becomes Your Building Permit When Approved
Building Official
Date
Paid .fo _
Date /1./&. {)J-
Receipt No. SlJ.1 &
By J:
u
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
/~r'as-
ADDRESS
/6..??9 ArL,,~~~ L?r
..
OWNER
CONTR.
PHONE NO.
PERMIT NO.
\ \"'/'/9'2
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
,;AJ ~ ~.....BING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS: _,~ / \"' /1 /'
(~Ce /?r ~ )0 f-~~he~
/
4/
/1/ etA.-/
~ ."
(4 //, j aI.A.-
./
0) /
/I /l4. t
/-
/J/
L/ C'---
~ATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO/~/ ~EINSPECTION BEFORE COVERING
Inspector: P" y~ --owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
/NSNOTl