HomeMy WebLinkAboutPlumbing 99-1035
CITY OF PRIOR LAKE
PLUMBING PERMIT PPNo. 17-/03':) .
Applicant: h'~t1" y:J.J2 f- -Lr ~1/ I"V #l~hone: -lj C / j. '1 V 0, _
Address:~J ~'I=\_::L~~. /~~f)~ €~~C 6,UJ~
Signature:/? r _ k fi.A
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Legal Description: Lot I Block / Sub H ILJ",0t3UKV
Site Address: ~')... L/3 ! ('(J ~ S--r'(UIV1r"F) R-4-
Building Permit # qCj'- ,/~::" c.:::>~ PID# 76- 357- OO(~Q.
NOTE: This permit will not be processed without complete information.
1. Blue
2, Gold
3, Yellow
File
Qty
Applicant
Th. C.nt., of the Lak. Country
FIXTURE UNITS
I
Quantity Type of Fixture
I Bath Tub with or without shower
J Dishwasher
! Floor Drain
;}:. Lavatory (bathroom sink)
Laundry Tray (1 or 2 compartment sink)
I Shower Stall
( Sinks
Bar Sink
~ Water Closet (toilet)
Quantity
.
Water
fj Ipe (washing machine)
e age Ejector
0)-. .. ,) Backflow Assembly Test
V Lawn Sprinkler
Other
FEE SCHEDULE
Industrial, Commercial & Multi-Family
(1 % of job cost, $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alterations
State Surcharge
$99.50
$39.50
$
$
$'1i.So
$ .50
GRAND TOTAL
$ qQ.OV
This permit is granted upon the express condition that said
contractor, shall comply in all respects with the ordinances
of the State Plumbing Code and the amendments thereof.
3J.~ 00 J..,. ~~IPT NO. ~ - {q - '1: r DATE
/~/S ATTEST
v_~
Call for all inspections 24 hours in advance.
16200 Eagle Creek Av. S.E. Prior Lake, MN 55372/ Ph (612) 447-9850/ FAX (612) 447-4245
An Equal Opportunity Employer
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