HomeMy WebLinkAboutPLMBG 06-0620
THIS FILE HAS BEEN
CITY OF PRIOJ CLOSED DUE TO
INACTIVITY 4/18/2008
REQUEST l~.n... .l'.u~1""\.L
INSPECTION SENT TO
HOMEOWNER 10-06
Date Rec'd
7. //.0(,
File
I City
ow Applicant
I PERMIT NO. O~. O~z.ol
ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
. 3-r!. fJ D4-. 6
OWNER
(Name) :\e.F~ -r-Ci y I 0-
"6fJJ 0 - ??U1-13
(Address)
APPLICANT
(Name)
CULLIGAN WATER CONDITIONING
6030 CULLIGAN WAY
MINNETONKA. MN 55345
(Addr~~~2) 933 7200
(Phone)
(Address)
(City)
(Zip Code)
(Contact Person)
APPLICANT PLEASE COMPLE
..~ <\PPLICANT SIGNATU
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain I 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 Residential. New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $~~
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
~.EO
.50
~O.CO
(Office llse Only)
This Application Becomes Your Building Permit When Approved Paid
Building Official
Date
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714