HomeMy WebLinkAboutPlg Permit 04-0161
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (1 or 2 compartment sink
Show
Sinks REQUEST FOR FINAL
Bar Si INSPECTION SENT TO
Water HOMEOWNER 01-06
FEES\';I1.1!.DULE
Industrial, Commercial & Multi-family 1 % of job cost with a $39.50 minimum
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 01-05
P"d9-"'-' ~ , L
(Please type or print and siJm at:. _~"__)
ADDRESS
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LEGAL DESCRIPTION (office use only) A ~
LOT X' BLOCK ADDmON rcX~ J41 tLM.cnJ
OWNER
(Name) Mi!r11J,...., G,lA.h ~; f!r-
(Address)
APPLICANT
(Name)
CULliGAN WATER CONDITIONil\IG
6030 CUU-IGAN WAY (Phone)
MINNETONKA, MN 55345
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(Address) (City)
(Address)
(Contact Person) -
r''JPLICANT SIGNATURE -0 ~ a
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Quantity
I
Estimated Cost $ 200-
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Omce Use Only)
( ~his Application Becomes Your Building Permit When Approved
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:ity
.pplicant
PERMITNO(?Lj_/6/
ZONING (office use)
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(Phone)
(Zip Code)
(Phone)
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DATE
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
"3 0,. ~
.50
"'0 r c)J
I Paid tit), ~~
Dat~ J I
Date ::::> -I Cj-O '-1
14 hour notice for all inspections (951) 447-9850, fax (951) 447-411s
16100 Eagle Creek Ave., S.E., Prior Lake, MN 55371-1714
. Receipt ht~q3 /
By g-
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BaUdln. OfIIclal
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14-3~ Wk7BYU6D~ 7ft-
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDA nON
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
COMMENTS:
OA TE TIME
if .(It,1
o EX/GRADIFILLlNG
o COMPLAINT
o FIREPLACE Rf
o FIREPLACE FINAL
o GAS LINE AIR TST
o
-sENT TW{)-REQUEST-S--FQR-
l.NSPF,C r~r 'ERS OUrl'
-REGEIVEIl-NO RESOONSE,
CLesE FIL~ Te
INA.rnVITY
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
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