HomeMy WebLinkAboutPLUMBING PERMIT (CANCELLED) (r:, PRIp Date Rec'd
AN , CITY OF PRIOR LAKE PLUMBING PERMIT z
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2►.B'"oM C` Fcity PERMIT NO.p, 1 3q /f
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3. Yellow Apptiapt
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
4560 Dakota St. SE k -z
LEGAL DESCRIPTION .ffice use only)
LOT s'ABLO K $to tilONjefit------<: '
OWNER Lyle &Alice Anderson
6/441• (Phone) 952-447-3870
(Nam(Address)
4560 Dakota St. SE , 1
APPLICANT Tri County Water Conditioning 952-447-2160
(Name) (Phone)
_ 5333 160th St. SE . . 0 . L3 6 62 S---- /-(14Z=1-tl ki.t t?6J 5-5-557•`
(Address)
(Address) (City) (Zip Code)
(Contact Person) Bill Corby (Phone) 952-447-2160
APPLICANT SIGNATURE DATE
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain 1 Water Softener
Lavatory(Bathroom Sink) Stand Pipe(Washing Machine)
Laundry Tray(1 or 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet(Toilet) Other
FEE SCHEDULE
Industrial,Commercial&Multi-family 1%of job cost with a$49.50 minimum Residential,New One&Two-Family $149.50
Residential,Additions&Alterations $49.50 r
Estimated Cost $ 750 Building Permit#
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PLUMBING PERMIT FEE $ •41JZ .\ t`
STATE SURCHARGE $ $1.00
TOTAL PERMIT FEE $ 5--o.JV
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid �'�;}` Receipt No. 7c-f0
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Building Official Date Date 1 a ss,- t co By
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372
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MEMORANDUM
DATE: Friday, December 16, 2016
TO: Janet Ringberg
FROM: Lynda Allen
RE: Plumbing Permit 16-1397
4560 Dakota Street SE
The contractor has requested this permit be cancelled. Please return half of their mechanical
permit fee ($24.75)to:
Tri County Water Conditioning
Post Office Box 65
Hutchinson, Minnesota 55350
Thank you. ' PC
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Lynda S. ' llen, l t
IVBuilding Services Assistant 1v" P
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