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HomeMy WebLinkAboutPLMBG 07-0778 Date Rec'd 1. Blue File 2. Gold City 3. Yellow Applicant I PERMIT NO. ()7.o11~ \ ZONING (office use) t-- LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION Pill 2.5. c . oo~. 0 OWNER LJ , (Name) rv....~ '^- 't f\) 0 'f i- 'r.. (Phone) (Address) 1'5 '3 3 -\- lLJ ~ APPLICANt.. (Name) 'K t'll---u- ltc.x.:Yt~V (Address) 14 S 3() d- l h v:\ ~ \\J. (Address) (Contact Person) ~\) e L{)Y\.Mu... V\ Y\. (phone) P l\lfY'LCU--{Vt (City) (Y\V0 5S447 (Zip Code) (Phone) ilo3. 5" 'C;~ '6 70"-1 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 I()~ 1 '1.i2 APPLICANT SIGNATURE e of Fixture 37S 0 C) Estimated Cost $ , Building Permit # PLUMBING PERMIT FEE $ STATE SURCHARGE $ TOTAL PERMIT FEE $ '3 ?'. 5 f) .50 ~.PO (Office Use Only) This Application Becomes Your Building Permit When Approved Date Paid +0,00 Date B ,,~.O( Duildin!!: Official 24 hour notice for aU inspections (952) 447-9850, fax (952) 447-4245 16200 Eagle Creck Ave., S.E., Prior Lake, MN 55372-1714