HomeMy WebLinkAboutPlumbing Permit 07-0043
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Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
CLOSE THE FILE
DUE TO INACTIVITY
2/10/2009
(Contact Person) (Phone)
APPLICANTSIGNATUR~n~ m~ DATE
APPLICANT PLEASE COMPLE~OW
Type of Fixture I Quantity
Bath Tub with or without shower I
Dishwasher I
Floor Drain I
Lavatory (Bathroom Sink) I
I Laundry Tray (lor 2 compartment sink I
I Shower Stall I
I Sinks I
I Bar Sink I
I Water Closet (Toilet) I
(Please type or print and sign at bottom)
ADDRESS
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNERn._
(Name),j.-.'T b ~(J
(Address) ~ As At-n~
APPLICANT
(N ame)
(Address)
(Address)
Quantity
FEE SCHEDULE
Industrial. Commercial & Multi-family 1% of job cost with a $39.50 minimum
Estimated Cost $ ~90
,. 2-4- ~ 67
I
Blue File
Gold City
Yellow Applicant
I PERMIT NO'01.CJ04.;'3
.
ZONING (office use)
PID
(~) ~Cv ,
(Phone) LiLt 0- I ~
(Phone)
(City)
(Zip Code)
f@/@CJ 161. 0
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
Residential. New One & Two-Family $99.50
Residential. Additions & Alterations $39,50
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office lise Only)
This Application Becomes Your Building Permit When Approved
31.56
.50
L-j(). en
Paid 4-0, 00
Date I. 1,5". 01
,
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
Receif No. 5Z-!J3r;
By 4. _ I
U
Building Official
Date