HomeMy WebLinkAboutPLUMBING 08-0948
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Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
~. ~~:~ ~!~y I PERMIT NO./)-a.. {)C}/01
3. Yellow Applicant , L V II l/' ,
ZONING (office use)
[Y
tiE
OWNER ~ (: / In", I /'. ,....
(Name)~ ~
(Address) ~(trn
. -
/11Cro~~, .
; Dr La ~
rY)~
I
(phone) ~~. 'Fib -1Ji!L I
553-7
PID
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
APPLICANT
(Name)
Champion
651-365-1340
3670 Dodd Rd. #100
~~dd~9jln, MN 55123-1339
(ContactPe",on) ~ S 01 en /. ~
APPLICANT SIGNATURE l,i;:lllt-<: . . --
(Phone)
(Address)
(City)
(Zip Code)
(Phone)
DATE
Quanti
APPLICANT PLEASE COMPLETE BELOW
T e of Fixture Quanti
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink
Laund Tra I or 2 com artment sink
Shower Stall
Sinks
Bar Sink
Water Closet Toilet)
e of Fixture
Machine)
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $49.50 minimum Residential, New One & Two-Family $149.50
Residential, Additions & Alterations $49.50
Estimated Cost $ 1.-OJ, OJ
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOT AL PERMIT FEE $
LfLj.5b
.50
c:::: '1 U-
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(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
c5o.
No. <-7 III
<,....,J
Buildine Official
Date
Date I ( If. (/:
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
7 c...f\fll I
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