HomeMy WebLinkAboutPLMBG 03-1549
THIS FILE HAS BEEN
CLOSED DUE TO
INACTIVITY 4/18/2008
CITY OF PRIOR LAKE
9524474245
P.01/01
Date Rec'd
,'Y OF PRIOR LAKE PLUMBING PERMIT
~
- .EQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 01-05
: :~: ~:~ I PERMIT NO. A_:?_. 1.5-ll'~
. Yellow Applioanl . It.- ]
ZONING (oilier life)
LEGAL DESCRIPTION (office: use only)
LOT { BLOCK ( ADDITION
{)l~~'OV ~+-
p
5- ~/0- ()O/-
IOWNER
(Name)
(Address)
~'{," ,,€.
Si~
U<,~
(phone)
APPLICANT
(Name)_
..
1628"'* HWV 10 Hi
MPLS., aN ...
.
(phone) J0'~'- '7 <E; 'S' 1o~ \
(Address)
(Address)
(ConractPerson) ~l(\v:lf>~ NC\Hlt
APPLICANT SIGNATURE _
(City)
(Zip Code)
(phone) ~.l d.. - ('~ I c\._ "S /1 ""
DATE
Quantity Type of Fixture Quantity TyPe of Fbture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater I
.Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
I Shower Stall Backflow Assembly
f Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
APPLICANT PLEASE COMPLETE BELOW
FEE SCHEDULE
Industrial. Commercial & Multi-falnily 1% of job eost with a $39.50 minimum
/ S'a I ~V/
Estimated Cost $ ~
Residential. New One & Two-family $99.50
Residential. Additions & Alterations $39.50
Building Pennit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(OffiCI! Use Only)
This Applieation Becomes Your Building Permit When Approved
-
Building Offiei,,1
Dllte
24 hour notice for all inspections (952) 447-9850, raJ: (952) 447-4245
1(il00 Eagle Creek AVl!.. S.E., Prior Lake. MN 55372-1714
TOTAL P. 01