HomeMy WebLinkAboutPlumbing 03-0441
,I
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
REQUEST FOR FINAL
INSPECTION SENTTO
HdMEOWNER 6/03
l ~~ ~:~ I PERMIT NO. 0 3~ Itl d
1 Yellow Apphcant 7~ n
(Please tvD~ or coot and sicm at bottom) ..
ADDRESS 150wLP Red
OaJc.s Rd. S tv
\ ~7SDOffi~U") \
PIDQ,5 -Ol/.;l-Ol'-~
(Phone) (q51)tfl/ 0'" 7 JCI V
LEGAL DESCRIPTION (office use only)
&poiloCK ADDITION!(~ flJM~
(Address)
Cuta(a
f 53LP U
I Al Fred
Reel Oal. 5
Rt). S t
OWNER
(Name)
~~;:~~NT _Norbl Dm' PitA mbfnJ
(Address) }tl05 &1arft"tld .Av. bo.
(Address)
(Contact Person) ~ N (J(bl (5YYL..-
./- 'PLICANT SIGNATURE _ /)/A/J/I ~_
'fI'!-' - '-
APPLICAN
Quantity Type of Fix
Bath Tub with or without e
Dishwasher ~
Floor Drain .
Lavatory (Bathroom Sink
Launory Tray (lor 2 compartm
Shower Stall
Sinks
- REQUEST FOR FINAL
INSPECTION SENT TO
Ii HOMEOWNER 8/19/03
(Zip Code)
FEE SCHEDULE
;t with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Penn it #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
2f1.~
.50
I.fO .~
~mce Use Only)
-'his Application Becomes Your Building Permit When Approved
r
Building Official
Date
r pai~I/t?, ---
I DaiV_Ib_03
Rect!L/t>73
B~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714