HomeMy WebLinkAboutPlg Permit 02-1596
CITY OF PRIOR LAKE PLUMBING PEAAul
Date Rec'd
(Please type or print and si2n at b~ ..u....)
ADDRESS
143loJ ~CDk.Ue.rG ~yt4. NW
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER .
(Name) ~,:s
"
~::~ ~:~ PERMIT NO. /,\'\ - IS Q }
3. Vellow Applicant (...b<. I ~
(3i2.)
ZONING (office use)
~J-
PII~5 -..~'84'" Ob q-O
~lf1'It1fh~ (Phone) C!52-133-iZID
( ~ ML .as a.wVG)
\
(Address)
CULLIGAN WATER COr.,,....-.-.....""
5030 CULLle, (Phone)
MINNETONKA, ii
'f";.f") go'n -'f'
(Address) , \..", . ..,J-I r;;.v", (City) (Zip Code)
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)
APPLICANT
(Name)
(Address)
(Contact Person)
vJL2'L' ~
APPLICANT SIGNATURE
Quantity
(Phone)
DATE
11-2/-02-
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
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
Estimated Cost $
d:JO/
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
Building Pennit #
$ 31. 50
$ .50
$ 40. CO
Paid L/IJ I oJ Recei~.3' '107
Date /;)-/?~ BY~
rJ
. ~IOR LAKE
II'It4:jPECnON NOTICE
DATE
"",:,,~<~
TIME '<"
SCHEDULED
I-fr
ADDRESS
/ (.{]c, {
fl~HV'"1"
OWNER
CONTR.
PHONE NO.
PERMIT NO.
d,/5Qb
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
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
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!tWoRK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: J1,It? / - &-'0 SOwner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH cl SAFETY!
lNSNOTl
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