HomeMy WebLinkAboutPlumbing Permit 15. 1186 J
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0BING PERMIT -
4 pRict6 ck$ 0 �� JOB342807 PO �� 91PCITY OF PRIOR LAKE PLUM Date Recd
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Z QoW FA PERMIT NO.
lease a or'riot and si: at bottom 3.Yellow Applicant � ■ ti/
ADDRESS
3449 Willow Beach Trl S ZONING(office use)
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LEGAL DESCRIPTION(office use oni )
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OWNER
(Name) Debbie Salisbury j
(Phone) 952-447-6641
(Address)site
APPLICANT
(Name)Ben Franklin Plumbing
(Phone) 612-238-9709
(Address) 5718 International Pkwy,New Hope MN 55428
(Address)
(City)
(Contact Person) Jennie wood (Zip Code)
(Phone) 812-238-9709
APPLICANT SIGNATURE DATE 9/24/15
Inteffall APPLICANT PLEASE COMPLETE BELOW
T i e of Fixture
MIIIIMIIIIIIIII Bath Tub with or without shower 1.1111111111 Quauti T e of Fixture
Dishwasher Rou:h-ins
11111111111111111
Floor Drain Water Heater 1
Lavato Bathroom Sink Water Softener 1
Laund Tra 1 or 2 coin artment sink Stand e e Washin: Machine
Shower Stall Sawa:o E
IMINININEEMINIMIMMINIMMEN
�� Backflow Assembl
Bar Sink Backflow Assembi Test
MWater Closet Toilet 1111111111111111
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The Minnesota Statutes FEE SCHEDULE
"S MCHAR O §3268.148... f joli cost with a$49.50 minimum
has been extended. Residential,New One&Two-Family $149.50
The i)tinimain sttreltat'ge for Residential,Additions&Alterations $49.50
"fixed fee"permit is$5.40 $ Building Permit#
PLUMBING PERMIT FEE $ • O
STATE SURCHARGE $ `5-r 1
(Office Use only) TOTAL PERMIT FEE $________622_,_50
This Application Becomes Your Building Permit When Approved Pai 76 Receipt No.
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Building official Date By -.
bate ♦ �
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372ir
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