HomeMy WebLinkAboutPlg Permit 02-1424
(Please type or print and sign at bottom)
ADDRESS
J 5~ I I '-~ i 3 -H()~ n p~.Gt; t-J W
LEGAL DESCRIPTION (office use only)
LOT I BLOCK (} ADDITION Vd~
Date Rec)l.
CITY OF PRIOR LAKE PLUMBING PERMIT
I" Blue File PERMIT NO ~
2 Gold City . () "} _ !u' . .
3, Yellow Applicant 0\.... ., l _
(3,2) ZONING (office use)
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t)lA
PID,dS'" 375'- O{)6'-o
OWNER ^ ;1" , / J I"
(Name)~~ ) t1-lJ) VI
(AdMe,,) L57,11 J3~ ~C; NvV
APPLICANT
(Name)
(Address)
(Phone) q5t?~C3{t l.P 1-=1f
CULLIGAN WATER CONDITIONING
6030 CULLlG,;r~ WAY
MINNETONKA, MN 55345
(AA~~~ ~""- noo
(Phone)
(City)
(Zip Code)
(Phone)
(Contact Person) /\ _ . . ~
APPLICANT SIGNATUR~ z1V1~ If.f~rG
'\ "-
Quantity
DATE
, () / 1 {) /02-
. .
.
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity I 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
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
FEE SCHEDULE
Industrial. Commercial & Multi-family 1% of job cost with a $39.50 minimum
(Office lJse Only)
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
3Q.lQO
.50
'f().OO
Building Official
Date
Paid LI 0.------
Date
10 ?5-~;)-
Receipt No. 'I
L/aq ~ /
B~
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ID-; ,
ADDRESS
/ {3/ (
(J IC") ~Of.-1
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
, , " ".--'f
/I )'1 ..." .Jl(J.,
IV V ! ..
:::::NO ~~ s-- ~
. --- -.-"
o PLUMBING RIO;;;" - 0 EX/GRAD/FILLING
o MECH RI JI.J~ L/ 0 COMPLAINT
o WATER HOOKUarlV'. 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLlNE AIR TST
o MECH FINAL 0
OWNER
PHONE NO.
COMMENTS:
Wi,{ I-v / ~ d~-r
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rfWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~~ ~ALL FO~ REINSPECTION BEFORE COVERING
Inspector: f '1/ (D-f 1-fY-..- Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INS/'iOTl