HomeMy WebLinkAboutPlg Permit 02-1244
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(O/~) ,
(Please type or print and sign at bottom)
ADDRESS
'5 27QU "Uff-t~~ PMb N V\J
I. Blue File PERMIT NO
2 Gold City ';1
3 _ Yellow Applicant U.
LEGAL DESCRIPTION (office use only)
LOT / tBLOCK LI ADDITION /1ulO/1 j) (),~
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PID..1'7" - 'Ig~ -ofo9-0
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(Phone) ql)) ... Lj LJ 1 ...LP dO I
APPLICANT
(N ame)
CULLIGAN WATER CONDITIONING
8030 CULLIGAN W,^, Y
MINNETONKA, MN 55345
{AdJPe~~} 900-72DD
(Phone)
(Address)
(City)
(Zip Code)
(Contact Person) .
APPLICANT SIGNATURE -=ill.QtltlLL ( \:c -J J!!-.M
(Phone)
DATE
q iJJ4D;Y
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
I Dishwasher Water Heater
I Floor Drain I Water Softner
I Lavatory (Bathroom Sink) I Stand Pipe (Washing Machine)
I Laundry Tray (] or 2 compartment sink I Sewage Ejector
I Shower Stall I Backflow Assembly
I Sinks I Backflow Assembly Test
I Bar Sink I Lawn Sprinkler
I Water Closet (Toilet) I 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 $ dOO. 0 ()
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
,?:>q.50
.50
4() _ no
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
I Paid . "U
71 i/O. 0
Date
fO.-ij-Or
Receipt No.
t.j ~f~' 6 h
BY~
f/
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
CIT'U)F PR'.OR LAKE
INSPECTION NOTICE
SCHEDULED
!()-lfo-02- to',/7
ADDRESS
16 ~ 1 4 J~~~-e}S -Pa-s"
OWNER
CONTR.
PHONE NO.
PERMIT NO.
0'2 - 1'2L{'/
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 EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
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COMMENTS:
,
'~xr~1V'.
ftK:A TIS FACTORY, PROCEED
o CORRECT A ON AND PROCEED
K, CALL FOR REINSPECT ION BEFORE COVERING
Owner/Contr:
850 P'd"'R THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl