HomeMy WebLinkAboutPlumbing Permit 09-0836
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CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
Ib.I4--.01
I. Blue File
2. Gold City
3. Yellow Applicant
I PERMIT NO.OC;" 0 133 ~
rY1iM't1 nSOY1 :[E; la,nct 1<U1d
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
Pill
~=R sn tJA%Y1
(Address) I SIt
8cnclt1fkr
(Phone) (95'&) Lf47 .L-JL/S2.
Quanti e of Fixture
APPLICANT f\ I f'TY" 1/\ 1 ~
(Name) I V V I (/ Vl) 1 , L
(Address) 1Yl OS
(Contact Person)
APPLICANT SIGNATURE DATE
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
$~
$ .50
$ nD. 0Jl
(Office Use Only)
Date
Paid 50. c/O
Date / (), /4-. (;
Receipt No. 57103/
This Application Becomes Your Building Permit When Approved
B uildin!! Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372