HomeMy WebLinkAboutPlg Permit 01-1104
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
(Please type or orint and sign at bottom)
ADDRESS
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ZONING (office use)
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LEGAL DESCRIPTION (office use only)
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APPLICANT SIGNATURE ~W ~ DATE ~l~ 101
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(JPPLIC'T PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain .
Lavatory (Bathroom Sink)
Laundry Tray (1 ( - --~.,rtment sink
Shower StalI REQUE
Sinks SENT ST FOR INSPECTION
Bar Sink NO TO HOMEOWNER 2/
Water Closet (T{ RESPONSE. CLOSE FILOl
OWNER
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(Address) ~o.NV\.F.
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Quantity
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Industrial, Commercial & Multi-family 1 % of job cost with a $39.50 minimum
Estimated Cost $
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Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
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Type of Fixture
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Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backtlow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
Residential, New One & Two-Family $99.50
Residential, Adgitions & Alterations $39.50
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Paid .At (}O
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~~<::eipt No. /7 "3 c
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