HomeMy WebLinkAboutPLMBG (LAWN IRRIG) 07-0660
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CITY OF PRIOR LAKE PLUMBING PERMIt[
Date Re.:'d
A!lr, 0 3 2007
I. Blue File
2 Gold City
3, Yellow Applicant
I PERMIT NO. 0 1. ~i~{"O I
ZONING (office use)
PUO
ADDRESS
/1/lu> .sTo/\/EB'IGIAK. UIL~
LEGAL DESCRIPTION (office use only)
LOT 4-BLOCK 4-ADDITION S'/OA/E:{1/Qn/C
PID Z!:::'-. 4&5. 0 2.& .0
I OWNER
(Name)
(Address)
(Phone)
"~.
'.
APPLICANT
(Name)
(Address)
PLY /'-10(./TH PLUrJ 8/ tJ(j
/22-70 43 ~p .5T ;/E
(Address)
(Phone)
'14-'3. 4-<?~, ('" / 0 ()
.:5r. HI crt/! 6 L
(City)
55370
(Zip Cbde)
(Contact Person)
(Phone)
APPLICANT SIGNATURE
DATE
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 )(J 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 $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
39: SO
.50
4-0, (j{)
....
Paid 4v--
Date .'-; 0
y ..).
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714