HomeMy WebLinkAboutPlg Permit 02-0636
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERlVul
(Please type or print and s~ at1:....._l
ADDRESS
dilL} WI' Ids ~
~:~~ ~!~ I PERMITNO'O,_1-3/1
3. Yellow Applicant d'I (Q ~
( .3'~)
?JJrD (offire use)
LEGAL DESCR1J:'uON (office use OnlY)J;G;J _
LOT /3BLOCK / ADDITION V14.a.-3&tj~
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OWNER \. I ... ,. &I Jh'
(Name) =.;I 1...!.!L1) klA ,an n on
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(Address) d 11 Lf vV,' I cL~ ~
APPLICANT CULLIGAN WAI t::t:{ COhlE;ITIONING
(Name) 6030 CULLIGAN WA~ _ (phone)
MINNETONKA, MN 05,,4..,
(Address) ~Q52) 933-7200
(Address) (City)
PIDtrS-3tJ1- 11/('6
(Phone) 3J:ff -t.JC/{p - /2- t7f~
(Zip Code)
(Contact Person) (Phone)
APPLICANT SIGNATU~ --MintA-) (\ffltLllL) DATE
APPLICANT PLEASE COMPLETE 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)
,CJ!2-OJ /D2.
Quantity
Type of Fixture
,
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washins Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
FEE SLlt.EDULE
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 $ '::;;;00. 00 Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
'-3q .S;;CJ
,50
a-rO.. 0 Q
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid I/o / ()C)
Date c5>:?r/',-tJ J-.
Receirq~/ 0- d-.
BY~
U
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
2774-
WIL.,-OJ
OWNER
CONTR.
PHONE NO.
PERMIT NO.
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
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
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d .r'\\, ~
. ese l-
DATE TIME
$,$1.1 2-. fJ, T.
A. /"1 '
LJJ.
~-to3~
(!),'-/~(p.t) .
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
~GASLlNE AIR TST
/' }h 0 <:nPf.
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, :\LL FOR REINSPECTION BEFORE COVERING
Inspector: b., ~ Owner/Contr:
CALL 447-9850 ;OR THJNEXT INSPECTION 24 HOURS IN ADVANCE.,
I/iSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETYl
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