HomeMy WebLinkAboutPlumbing Permit 07-565
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CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
I ~7;;~"'.~~d#
1. Blue File I PERMIT NO I
2. Gold City . 07.0SlPS
J. YeUow Applicant .
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LEGAL DESCRIPTION (office use only)
ADDITION
BLOCK
PID
.00 l. n.;,~. '0
IOWNER
(Name)
(Address)
(phone)
APPLICANT
(Name)
(Address)
(Contact Person)
APPLICANT SIGNATURE
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
N
Estimated Cost $ o<l!d
(Phone)
(Zip Code)
DATE
~ /;;., /I'~
Type of Fixture
I
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backtlow Assembly
Backtlow Assembly Test
Lawn Sprinkler
Other
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
59~1l
'O~ .50
~
$
$
$
(Office Use Only)
This Application Becomes Y ~ur Building Permit When Approved
Building Official
Date
Paid tf1J-
Date1. >. cr
!;+tJ
o.
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714