HomeMy WebLinkAboutPlg Permit 05-1239
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File PERMIT NO
2. Gold City . 05./"'~ q
J. Yellow Applicant ~ I
(Please type or print and si~ at bottom)
ADDRESS
15S) I (p Green 00 r.s \ riSE '-J-K50fY
ZONING (office use)
LOT
LEGAL DESCRIPTION (office use only)
BLOCK
ADDITION
PID J 5". r;} r-. () ( ~. ~
OWNER n
(Name) ,p+==~ KOIr-ey
(Address) ~ ~~ 8.b-n t='_
('l...-Y) .:::-r ,,/ " I
'"(Phone) ~- "-- ~
(Contact Person) (Phone)
<\PPLICANTSIGNATU6"'~ J..lYl~ DATEJrv~{)S
APPLICANT PLEASE COMPL~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)
APPLICANT
(Name)
(Address)
Quantity
CULLIGAN WATER CONDITIONING
~030 CULLIGAN WP.'!
MINNETONKA, MN 55345
(Addres~r52) 9a~ 7COO
(Phone)
(City)
(Zip Code)
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
I 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
(Office Use Only)
Estimated Cost $ ~ ,00
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
39!2()
.50
L(). 00
".1 This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid ~O -
Date. / /J (.....
/2 Z . v.I
ReceiPt~o. flJo' f"/
By -f-.
(/
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
ADDRESS
/b2t t
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED
-LL-~/,~r
~ Otf/L /'Y
CONTR.
PERMIT NO.
5";( Z3Cj
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
Wt1Ir/ .JUrt
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/WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~RK. &OR REINSPECTION BEFORE COVERING
Inspector: j/ /If " Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl