HomeMy WebLinkAboutPLMBG 05-1187
THIS FILE HAS BEEN
CLOSED DUE TO
CITY OF PRIOR LAKE PI INACTIVITY 4/18/2008
I
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 10-06
I ~f) 2 S
Lyo~s
4v-e.-
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
Me 1V1~hW\
t:....
(Address)
~;;~~ANT ~od~OW\ 11 Uwtbt
7-905 ~2tA dJ~ k S
(Addre~s) l
J€l( NPrb .
(Address)
(Contact Person)
PPLICANT SIGNATURE
ate Rec'd
5.05'
~L ~~~Iicant I PERMIT NO. OS-. lIe 7 I
ZONING (office use)
see-
f<-IS D
PID
(Phone)
(Phone) (to/?) B2fl-'f~
~IS ~~
(City) (Zip Code)
(Phone)
DATE
il Z-~-oS-
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher I 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
Water Closet (Toilet) 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 $
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
"his Application Becomes Your Building Permit When Approved
Building Official
Date
Building Permit #
~SO
r .50
lfu DD
$
$
$
Paid -/. () 0
rO.
DateZ. C' () ~
I . .~. ~
Receipt No. 5 d 9/1
By
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714