HomeMy WebLinkAboutPlumbing Permit #00-0858
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CITY OF PRIOR LAKE
PLUMBING PERMIT
Applicant: Aki?BJrJr-7 ~n,A.d<;AYc. Phone: "7f"..z'''7 -4't? ~-~
Address: ;;J.,9o~ ~'/P P,}h,),,U -:-::"tJ21- .vf.(;:'-~<.. <~t./CJCf(
Signature: ~~U~
Legal Description: I ( Block .J
Site Address: 5'-S:-2/; Li's-r H",R'.'~A.' C.''P/Jf'';' I~.
Building Permit # PID # d-5 -/(,c;- 0-30-6
NOTE: This permit will not be processed without complete information.
L Blue
File
2. Gold City
3. YelIow Applicant
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PPNo.
Th. C.nt., 01 tho Lob Counlry
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FIXTURE UNITS
Quantity
Type of Fixture
Quantity
Type of Fixture
Bath Tub with or without shower
Dishwasher
Floor Drain
I
Rough-ins
Water Heater
Water Softner
Bar Sink
Water Closet {toilet}
REQUEST FOR INSPECTION
~~NTTOHOMEOWNERlm3
RESPONSE. CLOSE FILE'
Stand Pipe {washing machine}
Sewage Ejector
Backflow Assembly (RPZ, Double Check, PVB)
qackflow Assembly Test
awn Sprinkler
)ther
Lavatory (bathroom sink)
Laundry Tray (1 or 2 compartment sink)
Shower Stall
Sinks
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
$
$
$ 7.{j , -sa
$ .50
GRAND TOTAL
$ tjtJ, ~
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.thNeof.
,-~gLf'/1,1 RECEIPT NO. Cj'-;)(7--DUDATE
c:; /I//~ ATTEST
Call ~ a17 i~spections 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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