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HomeMy WebLinkAboutPlg Permit 01-0165 The Cenler or Ihe Lake Counlry CITY OF PRIOR LAKE Pl-~M~/N PER'!IT Applicant: ~/~ ./ Address: /~7L/tJ ;;.,.~ (~A Signature: ~ ti , Legal Description: Lot Block Site Address: ..sLlI,? S;~ ~~&..;;, Building Permit # . I PID # NOTE: This permit will not be processed without complete information. 1. Blue 2, Gold 3, Yellow File City Applicant PP No. 01 . WIJ ~ Phone: 7',J.....~, q? .f'-- .I )") ....L I - Sub FIXTURE UNITS Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Dishwasher Floor Drain I Rough-ins Water Heater Water Softner Stand Pipe (washing machine) Sewage Ejector Backflow Assembly (RPZ, Double Check, PVB) Backflow Assembly Test Lawn Sprinkler Lavatory (bathroom sink) Laundry Tray (1 or 2 compartment sink) Shower Stall Sinks Bar Sink Water Closet (toilet) REQUEST FOR INSPECTION SENT TO CONTRACTOR. NO RESPONSE - CLOSE FILE FEE SCHEDULE 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 $31.~ $ $ $ .50 GRAND TOTAL $ 4-0. 0 0 This permit is granted upon the express condition that said contractor, shall comply in all respects with the ordinances of the State Plumbing C~de t mendments thereof. .3fo73 RECE 3-1, "LDATE ATfEST Call for all in spec Ions 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 /"