HomeMy WebLinkAboutPlg Permit 01-1240
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
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1. Blue File I PERMIT NO 2J./.o
2. Gold City 0/)'-1
J. Yellow Applicant Ut.
(Please type or print and sign at bottom)
. ADDRESS
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i-- A,' r Wit- "
t
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ZONING (ofliceuse)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
fA )t H.>I1IlA.u dJ
J
I-bmes
(Phone)
(Address)
APPLICANT
(Name)
/ftMfC-/J{vK uJk (Phone) '){,?- ;Jf{/r (j/I/~
(Address)
~ (Address) 1/1/1
(Contact Person) L..JA 112.... fit f/J& W
, ---------..
APPLICANT SIGNA TURE ~- -.--...-:.. '.._~ DATE
~LI{;~-;;LF.ASF, 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)
(City)
(Zip Code)
7 ~l. ' ;2 If/rJ ~ () I tis
) I-l-() J
(Phone)
Quantity
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
I
~O'1"nITO C;o,.,,+_p
REQUEST FOR INSPECTION
SENT TO CONTRACTOR. NO
RESPONSE - CLOSE FILE
FEE 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
Estimated Cost $ <6' t(J , '"
Building Permit #
Building Official
Date
31,~
.5.D
Af) ~W
Paid 4'tJ FoV
Date J / _I - (J I
Recei~'ll J
By ~
I
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245