HomeMy WebLinkAboutPlumbing Permit #00-0447
CITY OF PRIOR LAKE
PLUMBING PERMIT
Applicant: k""o- mIL. /l-07Y--L. Phone: SS-/ - ~.s~() .
Address: Ut90 ~'pI(J -II /J~; ,W.J /t-y/HouTIJ- uA/' ~ a lf~ /
Signature: ~ Ih""~
Legal Description: Lot sLrt -~ a~ Block~- aLSub~\0 It~
Site Address: 1'1 Zl/( /JLV~7rL L..K. /),n:. . -
Building Permit # f17"\- ~l..44'l PID#~'- c,~Y~-D
NOTE: This permit will not be processed without complete information.
1. Blue
2. Gold
3. Yellow
File
Qty
~t
PPNo.
OQ;:(jLJLf7
Th. C.nl., of lh. Lak. Counlry
FIXTURE UNITS
Quantity
Type of Fixture
Bath Tub with or without shower
Quantity
Type of Fixture
Dishwasher
Floor Drain
/
Rough-ins
Water Heater
Water Softner
Stand Pipe (washing machine)
Sewage Ejector
Lavatory (bathroom sink)
Laundry Tray (1 or 2 compartment sink)
Shower Stall
-;,.oi'-\;
o
R~~
~'r~
~A~
^ ........-:. ~ ~~
:::.~~~~ J~
~t'~~~""~ $39.50
... 9urchafge
.
Backflow Assembly (RPZ, Double Check, PVB)
Backflow Assembly Test
...~~
1'~
.,,', >':{, ;~'~
.....
[
$
$
$ ~,.,JQ
$ .50
GRAND TOTAL
$ ~.ot::>
~ - 5 ?OOl
16200 Eagle Creek Av. S.E. Prior Lake, MN 55372/ Ph (612) 447-9850/ FAX (612) 447-4245'
An Equal Opportunity Employer
l
~
III I