HomeMy WebLinkAboutPlg Permit 02-1348
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
(Please type or print and sign at bottom)
ADDRESS
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LEGAL DESCRIPTION (office use only)
I. Blue File PERMIT NO
2 Gold City . 0'
3 Yellow Applicant
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ADDITION
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OWNER \ \
(Name) T/LLi b ~ J \. J a XV\( /~ .
(Addresst 3LJ I?J F"O)(1n) J -r ~I I
APPLICANT
(Name)
(Address)
CULLIGAN WATER CONDITIONING
6030 CULLlG"Ai~ VVAY
MINNE~q~KA, MN 55345
(Add~) ~:M;j- {~UO
(Contact Person) /'.
APPLICANT SIGNATUR~iIfL (Ytu..uvJ
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Quantity
(Phone)(qF5~)lf4D .. ,3llJlJ
(Phone)
(City)
(Zip Code)
(Phone)
DATE
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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)
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
(Office Use Only)
Estimated Cost $ JOO . () 0
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
This Application Becomes Your Building Permit When Approved
Building Official
Date
39.50
. .50
YO. 00
Paid LjtJ.~
Date It) I V' d-.
Receipt 7:;,;; )(q3
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
CITY.C.: PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED 10-1$ OL
2:00
ADDRESS 3~, S For\Q.i-t- r::~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
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o FOOTING
o FOUNDATION
o FRAMING
o INSULA T/ON
o FINAL
o SITE INSPECT/ON
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASt..IflE AIR TST
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COMMENTS:
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~K SATISFACTORY, PROCEED
o CORRE N AND PROCEED
o CORR CT K, CALL FOR REINSPECT/ON BEFORE COVERING
Inspecto, . I; . . awne,lCo"",
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CALl.- 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI