HomeMy WebLinkAboutPLUMBING 06-1079
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(Address) ~CirnL 11 l oC La,~f M "-.\. S5~J;;;)..J
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(Address)
(Contact Person) V rt~ 0\ ~
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FILE CLOSED DUE
TO INACTIVITY
Sent Letter
JULY 10, 2008
(Please type or print and siJm at bottom)
ADDRESS
140117 ~~~ If\ NE
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
A.PPLICANT SIGNATURE
- ~LUMBING PERMIl
Date Rec' d
17/,0 .Ob
I. Blue File PERMIT NO
2. Gold City . '. I tJ11
3 Yellow Applicant fC1
ZONING (office use)
PID
(Phone) 1tfJ\ (~- \~tJ
fuAcw:WlN ~'SI~
&;Jty) (Zip Code)
~\~ ~V)-(2-J-fD
\\-I~'D'l
(Phone)
DATE
APPLICANT PLEASE COMPLETE BELOW
Quantity I Type of Fixture
I Bath Tub with or without shower
I Dishwasher
I Floor Drain
I Lavatory (Bathroom Sink)
I Laundry Tray (lor 2 compartment sink
I Shower Stall
I Sinks
I Bar Sink
I Water Closet (Toilet)
Quantity I Type of Fixture
I Rough-ins
I Water Heater
I Water Softner
I Stand Pipe (Washing Machine)
I Sewage Ejector
I Backflow Assembly
I Backflow Assembly Test
I Lawn Sprinkler
I 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::;;O, 0 0
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office lise Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Building Permit #
39.CSO
.50
40.0b
Paid 4D
Date / _
Il ,1 A) 1(;'
ReceiPr~o5 Z {, 'I L
,By I;
l
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
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