HomeMy WebLinkAboutPlg Permit 01-1306
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
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~. ~~ ~::y PERMIT NO./JJ,..../0 /l /
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ADDRESS
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ZONING (office use)
LEGAL DESCRIPTION (offire ure muy) Il '
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OWNER " fI HVl n 'll." 1../
(Name) lilAI'll (XI nYUf
(Address) Bl' H nwt1~ - f!f ~ 8.&
APPLICANT e 1or\,111\Vl
(Name) ~U lfA,V1 ,
(Address) \~lL{D tf11tl
(Address)
(Contact Person) ~, ^ YJlPJry
APPLICANT SIGNATURE ~M- IAWY
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APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
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(Phone) C l?j~ 1<.[q:?;
(Phone) ~-Lf?f]- ?JT7D
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(City) (Zip ode)
(Phone) CJf1 (oIOi 4/fJ-u'l!
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DATE
Quantity
Type of Fixture
Rough-ins
Water Heater
I Water Softner
Stand Pipe (Washing Machine)
REQUEST FOR INSPECTION
SENT TO CONTRACTOR. NO
RESPONSE - CLOSE FILE
t
F,EE SCHEDULE
Industrial, Commercial & Multi-family 1 % of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
34/50
$
$
$
50
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Estimated Cost $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid Lfo {}U
Datjl_ / w-O /
Reqb~d-/ j
BY~
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245