HomeMy WebLinkAboutPlg Permit 01-1249
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(Please type or print and sign at 1...VLLVU')
(3'1~
I
I. Blue File
2. Gold City
3 Yellow Applicant
ADDRESS I "Sq 1 vJ vJ
'1C I LDs View N
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
~V:~RLAfZR.~ e, ~uche\le.- ~~LLeVlGt
I
(Address) SAM-e... A~ ~nUL.,
(Phone)(ClSd--J ~33- ~LlL
.I
APPLICANT CULLIGAN WATER CONDITIONING
(Name) ov,)v-CULLlCAN WAY
MINNETONKA. MN 55345
I_U^":.I~O
(~s~-- .--
(Phone)
(Address)
(City)
(Zip Code)
(Contact Person)
(Phone)
APPLICANT SIGNATURE
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 $ a6D.o~
Building Permit #
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ :?fl, 8.)
$ .50
$ 40.0(')
(Office Use Only)
This APP~ Your Buildiug P;i~~ ~h;ul Approved
B'uilding Official Date
Paid 4'0 .0 C
Date 1/-/- (/ J
ReCei~/lfo~
By
...
;
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
DATE TIME
CITY OF PRIQR LAKE
INSPECTION NOTICE
ADDRESS
/'/5' 7
SCHEDULED '/12/~1..
W~ dU-uJ
A.. .'
OWNER
CONTR.
PHONE NO.
PERMIT NO.
D/-Iz..t.l Cf
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
ld. FINAL
b- SITE INSPECTION
o PLUMBING Rl
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 GAS LINE AIR TST
o
COMMENTS:
H7D ~.
"-.""r' . -- ,
,f
(~/ 1
~ ~/I
If
"
r' -
\ \' P.
/
~ORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORREC~~K' CALL FOR REINSPECTION BEFORE COVERING
Inspector: OwnerlContr:
.,
CALL 447-9850 FOI: THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREME~TS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
JNSNOTl