HomeMy WebLinkAboutPlg Permit 02-0225
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
3-/2-02-
1. Blue File
2. Gold City
3. Yellow Applicant
I PERMIT NO. () Z- ozztf"
I
W-_:'-md~U_~
I ADDRESS
7/7tJ Lt )L~_,,~
ZONING (office use)
he; ~
LOT
LEGAL DESCRIPTION (office use only)
PID
OWNER
(Name)
(Address)
APPLICANT
(Name)
(Address)
(Phone)
~ t:~r- vd r ')...~/? C;J
,.1-
(Zip Code)
(Contact Person)
APPLICANT SIGNATURE
DATE
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain I Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink REQUEST FOR INSPECTION Lawn Sprinkler
Water Closet (Toile1 SENT TO CONTRACTOR. NO Other
RESPONSE - CLOSE FILE
Industrial, Commercial & Multi-family 1 % of job cost with a ~.5Y.;JV mnlllDUIIl __-<dential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $ Building Permit # () z,.... 6 Z. 'lS'
(Office Use Only)
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.3 9. SO
.50
40.0 ~
omes Your Building Permit When Approved
Paid 4-0.0 0
Date ., By
3- '2..-0,-
:3- ,-2..-02-
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245