HomeMy WebLinkAboutPlumbing Permit 07-826
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Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
CLOSE THE FILE
DUE TO INACTIVITY
=~~_...:.._~ 2/10/2009
[ LJ '/ If 3 0_1H:h_fl Lan€...-
~L ~:Iicant I PERMITNO.O~ oez~
SS3 1'2.11 ZONlNG'__l I
LEGAL DESCRIPTION (office use only)
LOT BLOCK
ADDITION
PID
I ~:R ::r~
(Address)
r
~:;: ;:~~~V~
(Phone) '1SL. l.J &J {, - 1/32
APPLICANT
(Name)
(Address)
6030 CUWGAN WAY
MINNETONKA. MN 55345
(952) 933-7200
(Address)
(Phone)
(City)
(Zip Code)
(Contact Person)
(Phone)
APPLICANT SIGNATURE
DATE
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain I Water Softner
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 $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $ LeO{) I DO
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
3'1,50
.50
4() I DC!)
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid 4/0. <1 0
Date 8, 3D ,() 7
Receip o. 04('5'1
By
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714