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HomeMy WebLinkAboutPlg Permit 01-0009 t CITY OF PRIOR LAKE 0 ~{p3 Applicant: I~N::T .PhoneP~';;j- Address: ::, ~V J-, (1 ~, /h;/ Ifl A/aJ Iltp, r/1t-/ , Signature: tJ.~-e<J/( A~ Legal Description: Lot /4- Block / .Sub Gl-YIVWFtTCJe... ~ Site Address: 1sT)'; f!y,AI'okOV 1M Building Permit # I}n- ()f3{p3 PID# 2.5-3'7- O/~- ~ NOTE: This permit will not be processed without complete information. FIXTURE UNITS The Cenlt'r or the Lake Country Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Dishwasher Floor Drain 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) Other L)n ~ tCf:;;t0{~ CLOSED WITH BUILDING PERMIT 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 $ $ $ 2~ ~S7J $ .50 GRAND TOTAL $ fj l P:!!::. This permit is granted upon the express condition that said contractor, shall comply in all respects with the ordinances of the State Plumbing C and the amendments thereof. .3a~? RE . _1- 9. Q.L DATE ATIEST Call for all ins ections 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