HomeMy WebLinkAboutPlumbing Permit 09-0573
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Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
1. Blue File I PERMIT NO I
2. Gold City . /'Ilq _ r'] '<
3. Yellow Applicant '-' -\ --:> _~
ADDRESS
IISS'f7 OM ~
ZONING (office use)
"frr.1,'J
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER J 'ly)
(Name) I
f{-f.M ~ (''f/.''
(Phone)
qp- - 'f'l7- 7 61"8"
(Address) 1 rr'f1 Ofh-ft1q frr...t f
APPLICANT ,
(Name) r,pel?l"t- P(lI~,wo
(Address) 10710 r1iS5iS5,~pi BlvD
(Address)
(Contact Person) Nlfffllf/IJ
APPLICANT SIGNATURE
(Phone)
COCt'l f?f/P,J5
(City)
(Phone) ~(J;'70-7/71
DATE 7-3o-or
tsY3J
(Zip Code)
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 $
'to(J.oO
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
4'\ .50
.50
.~O
(Office Use Only)
Paid
50.~
1 (3U
Date
Dat
24 hour notice for all inspections (952) 447-9850~X (9527 447-4245~
4646 Dakota Street S.E., Prior Lake, Minnesota 55372