HomeMy WebLinkAboutPlg Permit 02-1072
Date Re\
CITY OF PRIOR LAKE PLUMBING PERMIT
(Please type or print and sign at bottom)
ADDRESS
1. Blue File PERMIT NO dG
2 Gold City . ,.., "1 _ 1;)"7. , '
3. Yellow Applicant r ./.:.?( 1(.,. -
(.372-) ZONING (office use)
16810 fM}-f~ fjdat NW
J J
LEGAL DESCRIPTION (office use only)
, LOTJqBLOCK -3 ADDITION
OWNER
(Name)
r
/J/ dda ~10l1_
L~O YlttYd .H-uJ<.
1?~ID ~11> t<.icJ:Jt. t-JW
PIf9,S -, =?g;J.- /)~ .3 ,-0
(Phonel9~2) ~2-cnsg
(Address)
APPLICANT
(N ame)
(Address)
CULLIGAN WATER CONDITIONING
6030 l,;ULLluAN WAY
MINNETONKA, MN 55345
(Address) (952) 933-7200
(Phone)
(City)
(Zip Code)
(Contact Person) (Phone)
APPLICANT SIGNATURE~JIl~ (\itJ.JeM
DATE
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)
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 $ 2DCJ - 00
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
",-~q .60
.50
40. 00
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid .
~(),
Datek ~~U- Od--
--
Receipt No.
L-I(~ '1
By ,
C;t/
./
}II';
07
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 "~
t;,'cJ?J
vF PRIOR LAKE
.,iSPECTION NOTICE
ADDRESS
/~-31{)
SCHEDULED 7.-- =3 - a.....
E ac;-&~ 'R."d~o
I I'"
OWNER
CONTR.
PHONE NO.
PERMIT NO.
d~/O-'~
o FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING ~ 0 WATER HOOKUP 0 FIREPLACE RI
o INSULA TIO 0 SEWER HOOKUP 0 FIREPLACE FINAL
~ FINAL 0 PLUMBING FINAL 0 GASLlNE AIR TST
o SITE INSPEC ION 0 MECH FINAL 0
COMMENTS~) Jog;- '~-r- () ~
(1f~
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~
I"
,
~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR~KFOR REINSPECTION BEFORE COVERING
Inspector: /1 Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI