HomeMy WebLinkAboutPLMBG 05-716
THIS FILE HAS BEEN
i. CLOSED DIJE TO
./ -(~ INACTIVITY 4/18/2008
PRIOR LAKE PLUMBING PERMIT
Date Rec'd
7- Z-!;, os-
"""...-=-n"" ./
~
EST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 01-06
I 'f
~~ ~:~ I PERMIT NO.O!;:. 671' - I
,How Applicant . \.JI .
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PIDzS. 301. o~3. 0
OWNER
(Name) Q....v l Ve..r
Lo- Sa-lie-
(Phone)
(Address)
APPLICANT / J
(Name) Lde--_4::
(Address) .3 i / ()
c/.-- So 1'l..5
t
KI / Mer
(Address)
-r'
_1M
;:>/1/;1-1 hI 'Aj
4j/le Af
(Contact Person)
:L-
DATE
7 - 2-1-oS-
PPLICANT SIGNATURE
r-L,
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 .. !!l~
- "
f Sinks -,-- Backflow Assembly Test -
Bar Sink REQUEST FOR FINAL Lawn Sprinkler
Water Close Other
APPLICANT PLEASE COMPLETE BELOW
INSPECTION SENT TO
Industrial, Commercial & MUlti_.~~MEOWNER 10-06
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
39' ,s-o
.50
'10 , 0 c'J
/.-COffice Use Only)
'his Application Becomes Your Building Permit When Approved
Building Official
Date
I Paid
Date
I ::ceiPt No
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714