HomeMy WebLinkAboutPLMBG 05-0318
THIS FILE HAS BEEN
CLOSED DUE TO
CITY OF PRIOR] INACTIVITY 4/18/2008
REQUEST FOR .LHU"\.L
INSPECTION SENT TO
HOMEOWNER 01-06
Date Rec'd
f: ?E;{JS
~~~ ~~~ I PERMIT NO. 05-. 03/0./
r'" ellow Applicant . {/ ,
ZONING (office use)
Spruce Tr-L Sv'-J
LEGAL DESCRIPTION (office use only)
LOT BLOCK
ADDITION
PID k'? I 7 z... 64-0, 0
OWNER P -hr. . ~J
(Name) G'\! le\--"I onu 'Ann
(Address) same
MOn118V\S'
(Phone) QS2 4LfllDt3 SCl
APPLICANT . tP
(Name) I
(Address) 3b1D
PlpeworKS
"Dodd Rd
(Address)
O.
(Phone) Jd2J
t::ltga n
(City)
,3bS 1~40
Sji23
(Zip Code)
(Contact Person)
Mrl5
(Phone) SO (ne
DATE 4-\S--OS
APPLICANT SIGNATURE
"--
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher \ Water Heater
Floor Drain Water Softner
Lavatory (BathroC" Cl~__L\ Stand Pipe (Washing Machine)
Laundry Tray (I C REQUEST FOR FINA Sewage Ejector
Shower Stall L Backflow Assembly
Sinks INSPECTION SENT TO Backflow Assembly Test
Bar Sink HOMEOWNER 10-06 Lawn Sprinkler
Water Closet (To. Other
APPLICANT PLEASE COMPLETE BELOW
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
OS: 0]/'/
Estimated Cost $ Building Permit # rJ
(Office Use Only)
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
~r.50
.50
40 . (XJ
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid 1-tJ. (/0
Date ,1 - J-
or . 2-s . "
Receipt No. if 9/3 ?
J
By ~.e_
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
4O.l)() CP