HomeMy WebLinkAboutPlumbing Permit 09-0441
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Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
t,.zu.oJ
I. Blue File I PERMIT NO /1
i ~~It~w ~~~licant . oq, 04+
ADDRESS
3~J~ IOdc/
ZONING (office use)
J2c/. cS VV
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
SWan k:
(Phone) 952- 7-210- /277
553
(Address)
APPLICANT
(Name)
Champion
651-365 1340
3670 Dodd Rd. #100
[a~Sd MN 55123 1339
/,-,ress)
'0.
(Phone)
(Address)
(Contact Person)
(City)
(Zip Code)
(Phone)
APPLICANT SIGNATURE
DATE
G-1.--")-O'7
Quanti
APPLICANT PLEASE COMPLETE BELOW
T e of Fixture Quanti
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavato Bathroom Sink
Laund Tra 1 or 2 com artment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
e of Fixture
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 $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
'-fCj. ?J
.50
-5<J. 00
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Buildine: Official
Date
Paid.5?J. (/[)
Date t. 2-1.- ~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
3 <11 'S'ao