HomeMy WebLinkAboutPlumbing Permit 15. 1009 LU
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a„90 CITY OF PRIOR LAKE PLUMBING PERMIT Date Recd
I. Blue File PERMIT Gold City RMIT NO.
3.Yellow Applicant `3- 0/�
lease 7' or t and Sl,� at bottom , -
ADDRESS V
I S lO i ^ j ZONING(office )
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION
PID
OWNER
(Name) 4 V / It 5
(Phone) / � — • �"
(Address)
APPLICANT
(Name) ' ce Connections Inc.
12850 Chestnut (Phone)
(Address) ;,,: , a • - MN 55379
( -480 (City)
OP
(Contact Person) " (Zip Code)
A (Phone)
APPLICANT SIGNATURE /II1 . 7
DATE ,,
APPLICANT PLEASE COMPLETE BELOW
�uanti T te of Fixture
Bath Tub with or without shower Quanti T l e of Fixture
Dishwasher _1 Rou:h-ins
Floor Drain 11111111111111111111
Lavato Bathroom Sink Water Softener
Laun. Tra I or 2 com.artrnent sink Stand ePctor
.e Washin: Machine Shower Stall Backflow E A
Assembl
Bar Sink Backflow Assembl Test
li _n Water Closet Toilet '
Other
FIndustrial,Commercial&Multi-family 1%of job cost with a$49.50 SCHEDULE
Residential,New One&Two-Family $149.50
Residential,Additions&Alterations $49.50
The Minnesota Statutes§326B.148 $ Building Permit#
"SURCHARGE"has been extended
The minimum surcharge for a PLUMBING PERMIT FEE $
STATE SURCHARGE $
"fixed fee"permit is 00
$ . Wig.
TOTAL PERMIT FEE $
This Application Becomes Your Building Permit When Approved Paid A
Buiiding Orticial Date 31.
41111/11111111111111
Date
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372