Loading...
HomeMy WebLinkAboutPlumbing 99-745 CITY OF PRIOR LAKE PLUMBING PERMIT PPNo. APPlicant:~;t./,uy Ge2<L_ ,(C4..~6fI..J("-Phone: "/2 L/70- f5'/-22.. Address: 2S7 v...) i g S'r tu~c..oA/01~ ft1~ ~38'7 Signature: ?---..: rf'~ Legal Description: Lot (/ '- Block Sub Site Address: LA~el--~,u'(- /~K /7! VIL,C1,.J Building Permit # qeJ - ? .? ~ PID #.25- CitJZ - 0 t'J 1- 0 NOTE: This permit will not be processed without complete information. Tho Conlor of tho Lake Country FIXTURE UNITS Quantity Type of Fixture Quantity s- 5- Bath Tub with or without shower Dishwasher Floor Drain Lavatory (bathroom sink) Laundry Tray (1 or 2 compartment sink) Shower Stall Sinks Bar Sink Water Closet (toilet) ., J/ I 3 FEE SCHEDULE Industrial, Commercial & Multi-Family (1 % of job cost, $39.50 minimum) Residential, New One & Two Family Residential, Additions & Alterations State Surcharge $99.50 $39.50 GRAND TOTAL L Blue 2. Gold 3. Yellow File City Applicant qtl-7~ Type of Fixture Rough-ins Water Heater (/"u STI'1N-r ) Water Softner Stand Pipe (washing machine) Sewage Ejector Backflow Assembly (RPZ, Double Check, PVB) Backflow Assembly Test Lawn Sprinkler Other ul!../VA-L- 00 ZOO - $ $ $ $ .50 ,~"1~- "--- ...........~ $ 20.0.~ ._-~\\ \ \ \ ' Thf, pennft i, ."nred npon th, "p'''' ",ndition ,hot ,,;l ~, contractor, shall comply in all respects with the ordinances \ \ . of the State PIO,"b. ~'I'd,"'n~ 'b,=f. \~ ,') \ "3!5C:;l4- RE . fol1&/QCJ DATE \j-' i , / _ ATTEST / r- ,../ Call for all in~ections 24 hours in advance. '--~~._--,-~._~-- 16200 Eagle Creek Av. S.E. Prior Lake, MN 55372/ Ph (612) 447-9850/ FAX (612) 447-4245 An Equal Opportunity Employer