HomeMy WebLinkAboutPLUMBING 06-1119
r"TT'-' nv DOTnO T .+. T/"T;' PLUMBING PERMIT
FILE CLOSED DUE
TO INACTIVITY
Sent Letter
JULY 10, 2008
Date Rec'd
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(Please type or print and siJtll at oottom)
ADDRESS ~
"1'P- 5 ~ C::;~/2fi-d(}
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~. ~~~ ~!~ I PERMIT NO. / . /llq
3. Yellow Applicant ~
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~tJ t::-. k ~ In'v ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID 2.5. oo(P. 067 . 0
~~e~R6n/ L V &;}~J:'n?/9-/lJ/IJ (Phone)q_<h?- q/R-c~.;?~/
(Address) ~~ 3 S (JL1 /2-/l-c.//P f2.";- ($'c;2/2- _~~ ~ _L:3~7c2.
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APPLICANV'?/ /./ J .1 (. ./ 7' ;5..j - /07 V
(Name) C-77A-7l1JO J/)AJ~/(I9-Z?'P_ c-~fi2 (Phone) Cl_4fJ- ~
(Address)cY;;t ,A/' .k3/J~~ I3rbe 61:1 gt-( /2/lI.~i tI/LLe- h1J() -~-::r':.::?7
Address) (City) (Zip Code)
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(Contact Person) -;-. /.),)).- ';/ ~ A.I ''/ (Phone) q~:9-.-4 ,:1:j,c;-- /'l?'9 ZJ
APPLICANTSIGNAT~~ 4?JLr /~ D~TE /..;;2-rPO.-ot;
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APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity I Type of Fixture
Bath Tub with or without shower l!ough-ins ~
I Dishwasher / (Water Heater ./
I Floor Drain I Water SOffiier
I Lavatory (Bathroom Sink) I Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 compartment sink I Sewage Ejector
I Shower Stall I Backflow Assembly
I Sinks I Backflow Assembly Test
I Bar Sink I Lawn Sprinkler
I Water Closet (Toilet) 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 $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
31.51>
.50
4-0 0 ()
(Office lJse Only)
This Application Becomes Your Building Permit When Approved
Paid
+0,00
IL. z.. 7 c.>c,
Receipt No. 5UzO
~~k :n /I
BY/~
I ---
Date
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Aye., S.E., Prior Lake, MN 55372-1714