HomeMy WebLinkAboutPlumbing Permit 95-0035 _
CITY OF PRIOR LAKE 3���, F �,,,«o
PLUMB/NG PERMIT # �,3':�
O � PRjO� ApPlicant•��� Phone• �� �
�, Address: . L, ���f
'�'' � Signature:
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V � Legal Description: Lot Block Sub:
Site Address• f �o � �� ,n � Q .5 �S17-- /d53
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Building Permit # �.3 -- fJ )�.5 Q� (9d...Z PID # ,7.5 � 9�— Q 0 y-/
��NNES��� NOTE: This permit will not be processed without complete information.
FIXTURE UNITS
Unit
Quantity Type of Fixture Amount Total
Bath Tub with or without shower $ 6.00
Dishwasher $ 6.00
Floor Drain $ 6.00
� Lavatory (bathroom sink) $ 6.00 G
Laundry Tray (1 or 2 compartment sink) $ 6.00
� Shower Stall $ 6.00 (p
Sinks: $ 6.00
� Bar Sink - - --
water c�oset �toi�et� CLOSED DUE TO
Rough-ins INACTIVITY 8/30/Ol '
Water Heater
Water Softner $ 6.00
Stand Pipe (washing machine) $ 6.00
Sewage Ejector $ 6.00
Backflow Assembly (RPZ, Double Check, PVB) $25.00
Backflow Assembly Test $10.00
Lawn Sprinkler $25.00
Other $ 6.00
Minimum Fee $25.00 � � . o�
SURCHARGE .50
GRAND TOTAL $ oZ �� .,�
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 ihe amendments thereof.
� b RECEIPT NO>3� .� DATE
ATTEST
Call for al] ins ions 24 hours in advance.
4629 Dakota St. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230 / FAX (612) 447-4245
AN EQUAL OPPORTUNTTY EMPLOYER