HomeMy WebLinkAboutPlg Permit 01-0895
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
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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LEGAL DESCRIPTION (office use only)
LOTI BLOCK 5ADDITION HFAJJnl'lNN ISI
OWNER
(Name)
Aj~.
(Address)
APPLICANT/) I A L J hI.
(Name) ~/II<<J. ~
(Address) 0 L/2 (}tt/hr iJH /I.
(Address)
(ConmctPe~on) ~
APPLICANT SIGNATURE ~.;f/~ ~#_
Quantity
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1. Blue File
2. Gold City
3. Yellow Applicant
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(Phone) q( ?c. ? IR 9 -- );;JO
(Phone) ~ (2.. {,....~.? V ~ )?-#
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(Cityf (Zip Code)
(Phone) V' I )... g if ~ sJlJ.
DATE P--;;4?-tJ I
Type of Fixture
,
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
}3ackflOw Assembly Test
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I CLOSED WITH SF BUILDING J:J!.lUflT 101-228 ON
i 8/23/01
......I.:J.I.:J "'~.J;I.I.:J:&IV~.I.:J
Industrial, Commercial & Multi-family 1% of job cost with a $39,50 minimum
Estimated Cost $
"/11 .!!!---
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PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
This A~" omes Your Building Permit When Approved
~. 20"'0/
IIdlng Official Date
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Building Permit #
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50
l/d-V(
$
$
$
paid4<J ,. c/V
Dats..
1"). ZI'J .6/
Receipt No,
_ +037J
B~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245