HomeMy WebLinkAboutPlg Permit 02-1558
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
(Please type or orint and si2l1 at bottom)
ADDRESS
2e4\ ~~+-'--v/lll ~
LEGAL DESCRil'nON (office use only)
LOT3 BLOCK 3 ADDITION /./ JJd/1 t~
&~e~~ $ Kevie, ~tfde~n(\
(Address) -3tlW as mv~
APPLICANT
(Name)
CULLIGAN WATER CONDlTiONir',lG
GOOO CULLlOAfJ '!VAY
MINNETONKA, MN 55345
(95~) ~33=1 ~vu
(Address)
(Address)
(Contact Person) (;\ _ /J. . _
APPLICANT SIGNATURE ~ ~ -..
~: ~~ ~:~ I PERMIT NO~ ") -'l.f~L::d-
3. Yellow Applicant U~ J..:,.J 0 I
5537 2-
ZO~r (office use)
PIDaS'3gJ..-D51-(?
(Phone[Q'52-) 2?:13- ,q 28
(Phone)
(City)
(Zip Code)
(Phone)
...
11-8-tJ2..
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 Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sir . Backflow Assembly Test
Ba REQUEST FOR INSPECTION Lawn Sprinkler
Wi SENT TO CONTRACTOR. NO Other
'- RESPONSE - CLOSE FILE
MA Y 2003 lEDULE
Industrial, Commerc,
~ _._.1__ ---- r._-" _ _,._ ..1I..nimum
Estimated Cost $ -.avO-
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(omu Use Only)
This Application Becomes Your Building Permit When Approved
Building Omcial
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
. 3C{ 50.
.50
A/) - r.cL
Paid I/o ~
Date /)..,5-0--
Rec~~4 I\t:}
BY~
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