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HomeMy WebLinkAboutPLMBG 07-0529 Date Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT & Z/., d7 /4&7tfC/ UflV-trt,4/vI ~ l-6 <!/r , ZONING (office use) I Blue File PERMIT NO 2. Gold City "07' . 0 5' 3 Yellow Applicant LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID 2- {'". uik. () 4-7, ,(;. OWNER (Name) (V\~V) ~ik V t" I' \ '"" '- (Phone) b 1).- ") (J I ~ 31 () ~ (Address) APPLICANT \ \ (Name )=P (' (}. ~ (' ~ \.. C. \' \ -.J.-.. \:,. A.~ (Address) 'Sfa'I"> l..J. \ 1 o-vLV {'jC'J..J .s t- (Address) (Contact Person) (Phone) "" ~ .). ~ 4 '-11 . j 1 (, J Pr:\Jr C~k\.. )).31.>- (City) (Zip Code) (Phone) ~ J-X <.. 1')...46 S ~ C""'\ d.. Y "\ DATE '" r ).1-0 1 APPLICANT SIGNATURE APPLICANT PLEASE COMPLETE BELOW 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 Sinks Backflow Assembly Test Bar Sink yJ Lawn Sprinkler Water Closet (Toilet) l- ather 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 $ Building Permit # PLUMBING PERMIT FEE STATE SURCHARGE TOTAL PERMIT FEE $ $ $ (Office Use Only) This Application Becomes Your Building Permit When Approved .2Q.. ft ,/ 4-tt .k'v Re.s;e. ipt No. '-1.1 ,.../, l j ~ 7 (.)&{ v Paid Building Official Date Date &, l/It.' 7 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714