HomeMy WebLinkAboutPlg Permit 02-1494
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
(Please type or print and sign at bottom)
ADDRESS
2.915 Pine V j ~v-J 1)((
LEGAL DESCRIPTION (office use only) <'
LOT' BLOCK 4 ADDITION JlvL W J.&.a
OWNER
(Name) ~S<.. Ba (ltdJ
(Address) 2-q Je) PJ'~ V}/"AI rw
APPLICANT
(Name)
(Address)
CULLI(,:iAN WATER CONDITIONING
6030 CULLIGAN WAY
MINNETONKA, MN 55345
C952l 933-7200
(Address)
(Contact Person) (l
APPLICANT SIGNATURE -Ar11J't~1t (\ 1't'ytM
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)
I. Blue File
2. Gold City
3. Yellow Applicant
PERMIT NO.()~ - Ilfqi(
(3,2;
ZONING (office use)
tu5.0
PIro<S .. ;)1:;'}- (jLfO.-$
(PhOne)(~- LlSLP2
(Phone)
(City)
(Zip Code)
(Phone)
DATE _J 0 /21 /D2-
, ,
Type of Fixture
1
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backtlow Assembly
Backtlow 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 $ 260. QQ
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
3Cf ~ 50
.50
YO. Q1.2
Pai"l t. c;rf)
c/(},
Date
RlIJq65
jBYfY
24 hour notice for all inspections (952) 447-9850, fax (95 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 553 2-1714
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
Q1lS ri?~}
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
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:
Q~
Q. " /
r \ {j(_\/V
J\ \\
DATE TIME
1./. 'J..l(. 0'3
)0:00
()J-
"L- IWe;
o EXlGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
YCit~~~l.:j
---
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
RK CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
OR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
INSNOTI
IREMENTS ARE FOR YOUR PERSONAL HEALTH Ie SAFETY!