HomeMy WebLinkAboutPlg Permit 02-0482
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CITY OF PRIOR LAKE PLUMBING PERMI.
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ADDRESS
54;A ~ (11-,~E
I. Blue File I PERMIT NO
2. Gold City . /")'1 _ <-./011
3. Yellow Applicant {./ p\ 7 (J ""
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ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT
BWCK ADDmoNL2f~d (fl/G 4/:::) D~9
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OWNER
(Name)
(Address)
APPLICANT
(Name)
(Address)
CULLIGAN WATER CONDITIONING
RO~O (,;lJll iG.L\N WAY
MINNETONKA, MN 55345
((01:-2) 9'?~
(Address)
(Phone)
(City)
(Zip Code)
(Contact Person)
(Phone)
APPLICANT SIGNATURE
DATE
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 )G' Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
I Shower Stall Backflow Assembly
I Sinks Backflow Assembly Test
I Bar Sink I Lawn Sprinkler
I Water Closet (Toilet) I 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 $ ~ .CD Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERNDT FEE $
0Q, 6-D
.50
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(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid If 0,.00
Date6"'3~
RLIlt No.
B ,Y1tJ2J
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
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-
ADDRESS
D4-Z-o;
FAWN VI
OWNER
CONTR.
PHONE NO.
PERMIT NO.
() '2- - 0 4-e7
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP @ 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GAS LINE AIR TST
o MECH FINAL )d -.Hz.. 0 ~-r:
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COMMENTS:
Jl WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
'_DO ~, Qwne,lCoo'o
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI