HomeMy WebLinkAboutPlg Permit 05-1226
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(Please type or print and si~ at bottom)
ADDRESS ZONING (office use)
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I. Blue File PERMIT NO ~
2. Gold City . /'II::""', I Z Z
3. Yellow Applicant ~
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER t"""'" I
(Name) n~f\4. ~ t-'6 ~ '5 ;
(Address) ~)Y\{>
(Phonerts -;;) - t.I '10 ~ 9/??J ~
APPLICANT
(Name)
CULLIGAN WATER CONDITIONING
JOan CULLIGAN 'y'JJAY
MINNc: luNKA. MN 55345
(AddrA&~2) 933-1200 (City) (Zip Code)
'Contact Penon) ~ ('~ a~~ (phone) Ci\ J. - '11;)..- /)-W
I APPLICANTSIGN~TURE t~~~--- V-il~-"^ DATE }) - J./-() ~
. ~;LICANT PL~~E ~MPLETE BELOW -----
Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain Water Softner
I Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 compartment sink I Sewage Ejector
I Shower Stall I Backflow Assembly
I Sinks I Backflow Assembly Test
I Bar Sink I Lawn Sprinkler
I Water Closet (Toilet) I Other
(Phone)
(Address)
Quantity
FEE SCHEDULE
Industrial, Commercial & Multi-family I % of job cost with a $39,50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $ ~...
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
~~. ~
.50
l..f.0. on
$
$
$
\ffiee Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid 'fa , fI7.)
Date.., ,-
/Z.v().4J
Receipt ~o. 6lJ 8:Jif-
BY~
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 TIME
CITY OF PRIOR LAKE l~
INSPECTION NOTICE SCHEDULED
ADDRESS illS RQ$(>. 6<1J,:_~.
v
OWNER CONTR.
PHONE NO. PERMIT NO. ~ - I 7.:Z&
,
o FOOTING o PLUMBING RI o EXIGRADIFILLlNG
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 ..Ja'1SLUMBING FINAL o GASLlNE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS:
1
~.~.JcQ
~,~ ~
./
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORgR~K' CALL FOR REINSPECTION BEFORE COVERING
Inspecto . n ......---... Owner/Contr:
CAL 7\;JsO FOR JE NEXT INSPECTION 24 HOURS IN ADVANCE.
'NTS ARE FOR YOUR PERSONAL HEALTH cl SAFETY!
INSIiOTl