HomeMy WebLinkAboutPlg Permit 02-0050
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CITY OF PRIOR LAKE PLUMBING PERMITPOSTEbatf:tDZ-
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I. Blue File I PERMIT NO I
2. Gold City . '0'7 ""'Oo.l~O
3. Yellow Applicant ~ t,;:..I ·
APPLIC~~TC ' ~
(Name)~ -r\1..\ ~ C\-- ~O"'_~ (Phone)
(Address) 1oDs- \~~ ~.~ <; \.br2lUh~ <.~~'-\~
(Address) (City~ (Zip Code) -
(Contact Person) ~\ 6\ (Phone) CV;:.~...C('\-<1~
APPLICANTSIGNAT~ ~ _ ~~ DATE __ ~rl.'-\.Io I
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom S; .,
Laundry Tray (lor 2 C REQUEST FOR INSPECTION
S?ower Stall SENT TO HOMEOWNER. NO
BS1nkSs.nk RESPONSE - CLOSE FILE
ar I 4/2003
Water Closet (Toilet)
(Please type or print and siJ;lll at bottom)
ADDRESS
lSS~~
St.~
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER ()
(Name) \<..\.('~
R\..L~ \cv:i
(Address)
Quantity
FEE S\;IU.DULE
Industrial. Commercial & Multi-family 1% of job cost with a $39.50 minimum
(j)
Estimated Cost $ 9. W
ZONING (office use)
I€/SD
PID 25 -1t/..;3 - 0.3(.,'" O!
(Phone) qes-a - ,\\\-, - '-\~\~.
Type of Fixture
\
Rough-ins
Water Heater
Water Softner
~tand Pipe (Washing Machine)
ewage Ejector
,ackflow Assembly
ackflow Assembly Test
awn Sprinkler
lther
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
'?A SO
l.\n~t; .56
$
$
$
(Office Use Only)
;Y our Building Permit When Approved
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Date
pai~O . (iQ
Date l L
t-IT...OV'
Receipt N4/, sf--
By A/~.".______,"
. r4(X.
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
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