HomeMy WebLinkAboutPlumbing 07-0278
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Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
e or rint and si at bottom)
ADDRESS I
1(009,/ ~nKlin Ty--q;l SE EJ5300l
1. Blue File I PERMIT NO. ~
2. Gold City ~1
3_ Yellow Applicant e'J t -- I-
ZONING (office use)
LOT
ADDITION
LEGAL DESCRIPTION (office use only)
OWNER~
(Name) . _y ~~Ier
(Address) SCVYY . ~
APPLICANT
(Name)
CULUGAN WATER CONDITIONING
G030 CUll 'GAN WAY
MINNETONKA, MN 55345
~952) eJ3 7200
(Addr ss)
(Phone)
(Address)
(City)
(Zip Code)
(Contact Person)
APPLICANT PLEASE COMP
BELOW
APPLICANT SIGNATU
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain I 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 $ c:;::t:() r::;t:J
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTALP IT FEE $
39h
"' -J.)
.50
Lio.oo
"P
Paid
40. -
24 hour otice for all inspections (952) 447-9850, fax 952) 447-4245
00 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714