HomeMy WebLinkAboutPlumbing 99-231
OX PR/OfT CITY OF PRIOR LAKE
~~ ApPlicant:~~~'';}::;Z~ Phone,
Address: ~< I ~ /~. _.4. 'C / ~
Tho Con.o, of tho Lob Counlry , J " -~( :'!/ ~
"", f'G- Signature:, __ -. .
~ 'ltW ()J Legal Description: Lot! Block. Up SUb~V) ~ f/J<7'J() t a( (C
";) U Site Address: ,lk r::; ~ C ~c h _dc./"C - > c::. ~L Y LJ f) - 0']")
Building Permit # {C~ PID # ~~ -cfttl - 01 )-D
NOTE: This permit will not be processed without complete information.
J. Blue File
2. Gold City
3. Yellow Applicant
# Cl q ~ 231
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FIXTURE UNITS
Quantity
Type of Fixture
Quantity
Type of Fixture
Bath Tub with or without shower
Dishwasher
Floor Drain
x
Rough-ins
Water Heater
Water Softner
Lavatory (bathroom sink)
Laundry Tray (1 or 2 compartment sink)
Shower Stall
Sinks
Bar Sink
Stand Pipe (washing machine)
Sewage Ejector
Backflow Assembly (RPZ, Double Check, PVB)
Backflow Assembly Test
Lawn Sprinkler
Other
Water Closet (toilet)
FEE SCHEDULE
CLOSED DUE TO
INACTIVITY 1/1/03
Industrial, Commercial & Multi-Fa
(1 % of job cost, $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alterations
State Surcharge
:ti
$99.50
$39.50
$
$ 3C( --~
$ .50
GRAND TOTAL
$Cb .co
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230/ FAX (612) 447-4245
An Equal Opportunity Employer