HomeMy WebLinkAboutPlg Permit 02-1559
CITY OF PRIOR LAKE PLUMBING PERMIt
Date Rec'd
(Please type or orint and SilUl at b~~~_)
ADDRESS
\43b~ ~ook.rre.re. '"E:>\vd. NW
LEGAL DESCRIPTION (office use only) r
LOT\.~LOCK ;LADDITION ~ U LfUA.r
~~e~~k.uCS * Coll~~ t3h.-vnric.n
(Address)
APPLICANT
(Name)
(Address)
(Contact Person)
~ 01. S ~D ve.....
CULLIGAN WATER CONDITIONING
OU\:5U vULLlljP;~\j V\,/,t\.Y
MINNETONKA, ~IH".J:;'~5
(Address~952) 933-7'2CO
APPLICANT SIGNATURE
vi ~,-~ ~
Quantity
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)
~::~ ~~~ I PERMIT NO./1J"L, J' /"'slb
3, Yellow Applicant VC?< ./.j, 1
95~'2-
ZONING (office use)
K~
PID .d5" -. J, RtJ- IJh 9.1- ()
(Phone)Q?2,.-2-l0- a?4b
...
(Phone)
(City)
(Zip Code)
(Phone)
DATE
//- /2-62-
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 $ ~. (;;)(L
Building Permit #
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
$-3CLSO
$ .50
$ Men
Paid I/o, ~
Date /J...S.... d-
ReClJ;;~ ~9
By cr-
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
14Yt,~~ ~e.-
v
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:
. Q)
(R..J _,
, 1 I v
~') '.l I I.
~ '
DATE TIME
'f !~ olt'3
~( 5'S\
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
A 0 G.6;S}.INE AIR TST
"\ Ii!f" br~ 0
~~
;
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Owner/Contr:
Inspector: ~
,
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!