HomeMy WebLinkAboutPLUMBING 08-0223
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CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
~. ~~ ~!tey I PERMIT NO. D.- 22.3/
J , Yellow Applicant . tJ ,
ZONING (office use)
Po.. (' k '-"l~ '1
NJ
.55 3 [ l
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
~v'\ V"\ ~C\.j ~
3~~ ~\ \~.s
(Phone) b \ ~ - l.\ 9 a - d. 3 <t 9
(Address)
APPLICANT
(Name)
ClJLUGAN WAfER CONDITIONING
6030 CULLIGAN WAY
~A~lH~rpNKA, MN 55345
(952) 933.7200
(Phone)
(Address)
(City)
(Zip Code)
(Contact Person)
\PPLICANT SIGNATURE
Quantity Tvpe of Fixture Quantitv Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain I Water Softener
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
APPLICANT PLEASE COMPLETE BELOW
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $49.50 minimum Residential, New One & Two-Family $]49.50
Residential, Additions & Alterations $49.50
Estimated Cost $ d OD. D ()
Building Permit #
(Office lJse Only)
I
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
,-\q.50
.50
5D. DO
This Application Becomes Your Building Permit When Approved
Buildine: Official
Date
Paid 60, U2J
Date4-. f to!, 0
o. 5s7/ 2..
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372