HomeMy WebLinkAboutPlg Permit 02-0501
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
s -I "'02-
(Please type or Drint and SilUl at L..~~)
ADDRESS
EiLwn !Attu'6W ~)~ ~~ ~
~. ~~ ~~~ PERMIT NOo() 2.- 01 ~ I
3. Yellow Applicant ...J
"-
<..(5372) ZONING (ofticeuse)
5~GO
LEGAL DESCRIPTION (office use only)
LOT BLOCK
ADDITION
PID 2,.5 -,179'-()fB-~
OWNER J-
(Name)00hne:on J e::,Y~,y-n
(Address) .....c;yF)[) ~ n ~W
(Phone) %d.... <<tY 0 - 9.OfL2.
QuY1JL Se
(Address)
CULLIGAN WATER CONDITIUNINl:i
R030 CULLIGAN WAY
MINNETONKA, MN 55345
{Q~2) 933.1200
(Address)
(Phone)
APPLICANT
(Name)
(City)
(Zip Code)
(Contact Person) :"""\ (Phone)
APPLICANT SIGNATURE ~ ~ DATE ~~/(J-/JO~
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain I Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray {lor 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks I Backflow Assembly Test
Bar Sink I Lawn Sprinkler
Water Closet (Toilet) I Other
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
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
()Z~()50/
$ '-- ~q -.SO
$ .50
$ t+O. DO
Estimated Cost $ a-cx::J. 00 Building Permit #
(Office Use Only)
This APPli~ur Buildiug P~~;h::;Z:V'd
Building Official Date
pai~. Cf7)
Dat:s- -t' -02-
Receip~2.0 /2-
By ~ _
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
FcuP?! IJUa=chz.o
51)/
OJ"'~~
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEOOLED
ADDRESS
6' tfSCJ
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
C ~SULA TION
C FINAL
CI' SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
cSi~
COMMENTS:
I _
71"--
V'
/7f 11... /l ,
(JAUV'-
DATE TIME
Lf-~L{-()3
o EXlGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
SII-
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTl