HomeMy WebLinkAboutPlg Permit 01-0173
CITY OF PRIOR LAKE t ~~:~ow ~~~licant
!!.!:#.JAB!fJG~MIT PPNo.-O)-OI13
Applicant: ~~ ~ _ /phone,: ,9cl~ ~S/~J'-;")Q
Address: S7?0- ~...... i . tJC-. fJ ~ - .
Signature:
Legal Description: Lot Block Sub
Site Address:A)?2ii6 ~V1 WaJev iv,tli, \ ~
Building Permit # PID #
NOTE: This permit will not be processed without complete information.
FIXTURE UNITS
The ('en'e, of the Like Counlry
Quantity
Type of Fixture
Quantity
Type of Fixture
Dishwasher
Floor Drain
Lavatory (bathroom sink)
Laundry Tray (1 or 2 compartment sink)
Shower Stall
Sinks
Bar Sink
Water Closet (toilet)
\
Rough-ins
Water Heater
Water Softner
Stand Pipe (washing machine)
Sewage Ejector
Backflow Assembly (RPZ, Double Check, PVB)
Backflow Assembly Test
Lawn Sprinkler
Bath Tub with or without shower
"",...L..__
FEE SCHEDULE
REQUEST FOR INSPECTION
SENT TO CONTRACTOR. NO
RESPONSE - CLOSE FILE
Industrial, Commercial & Multi-Family
(1 % of job cost, $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alterations
State Surcharge
$99.50
$39.50
$ S If.S'O
$
$
$ .50
GRAND TOTAL
$ '-/o.ed
This permit is granted upon the express condition that said
contractor, shall comply in all respects with the ordinances
of the State Plumbing Code and the amendments thereof.
~'\68.C( RECEIPT NO. 3-'C;-?LJItII DATE
V!A A TIEST
Call for all inspections 24 hours in advance.
16200 Eagle Creek Av. S.E. Prior Lake, MN 55372/ Ph (612) 447-9850/ FAX (612) 447-4245
An Equal Opportunity Employer