HomeMy WebLinkAboutPlumbing 07-0493
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CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
&r /5. 07
;:~ ~!~ I PERMIT NO. 0'7. OLUl 31
3. Yellow Applicant , -, I ,
ZONING (office use)
6uro / jv!//II/lJ6-50/71 -ST~ET
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
I OWNER
(Name)
(Address)
(Phone)
APPLICANT _
(Name) ;:;/N/l//lU P~/I1.t>9'
(Address) 2E3qq~ L/ tVQc;/J I'tVb'
(Address)
\~iJ AI. c leU' fs. JrJ
(Contact Person) \...J
(Phone) {, f Z. . &, ~~. /9t. 3
L{N9S;?z~n 5fO ~
(City) (Zip Code)
APPLICANT SIGNATURE
(Phone)
DATE
6 - lIi'"--o7
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain 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 I
Water Closet (Toilet) V. Other /,,?e've (z) VC-N!J -S
/
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 $
37,s"V
.50
-f-O ~ c-v
Paid LW; '/} )
7 L' .-i'v
Date / . r 7
~ I.Lr;
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714