HomeMy WebLinkAboutPlg Permit 05-1225
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
CULLIGAN WATER CONDITIONING
oU30 (jULL/<.:iAN WAY
MINNETONKA. MN 55345
.. A (Address) (952) 933-7200
'Contact Person) f1i() rr ~ 0 ~ OkP,..j( (lnC.t:J
I APPLICANT SIGNATURE"\J rQ[ ~Q_^.OfLlV\~ Q l'_
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APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity I
Bath Tub with or without shower I Rough-ins
I Dishwasher Water Heater
I Floor Drain Water Softner
Lavatory (Bathroom Sink) I Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink I Sewage Ejector
Shower Stall I Backflow Assembly
I Sinks I Backflow Assembly Test
Bar Sink I Lawn Sprinkler
Water Closet (Toilet) I Other
REQUEST FOR FINAL
INSPECTION SENT TO
(Please type or print and sign at bottom) HOMEOWNER 10-06
ADDRESS
'-\l~.f~f\c\QLz St-
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER Q
(Name) ...)h~,j_'.o Y\
(Address) S("!,. 'N\ <l-.
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APPLICANT
(Name)
(Address)
Quantity
FEE SCHEDULE
Industrial. Commercial & Multi-family 1% of job cost with a $39.50 minimum
Estimated Cost $ _)'(f:) .--
; ~:~y I PERMIT NO. OIL, /2 Z~.
ow Applicant ~.:::;;
ZONING (office use)
PID
(Phone) ~ 5 ). . ~<i ~ '-dJy)L
(Phone)
(City) (Zip Code)
(Phone) Cf SJ- -q I A - 7 2;1/7
DATE~:;L -()~
-
Type of Fixture
Residential, New One & Two-Family $99.50
Residential. Additions & Alterations $39.50
Building Permit #_
PLUMBING PERMIT FEE
STATE SURCHARGE
TOT AL PERMIT FEE
flice {Jse Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
$ :,cl. Cf)
$ .50
$ i.J()_ 0(/
Paid 10, f/lJ
Date
1"l..U..O,J'
Receipt No. 5lJ fJf ~
BY~
I
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 OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
~.-/
L./ '"7 ,.
. G: '-(
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION "
Ja"FINAL &;,0"<
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
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DATE TIME
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1,1 L! I
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o EX1G~/
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
.~'''''
/~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CAL~OR REINSPECTION BEFORE COVERING
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Inspector: V / Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!