HomeMy WebLinkAboutPlg Permit 02-0865
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File
2. Gold City
3. Yellow Applicant
PERMIT NOt:'~ --8 ~
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/,If 9 ?S r-- '),; IJJ /fJ /7 {--/Ilde
NW
ZONING (office use)
plJiJ
LEGAL DESCRLyuON (office use only)
LOT ~LOCK I ADDITION ~ ~;;oILt::li
.....
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(Address)/~t? gS- ~d e/.2.C!..j~ JtZ()
APPLICANT/ J _ . _ . / h.
(Name) ~t1..-6:!'/--I7IL ~
(Address) -tt ~ * -&;'c//!I-/~
~. c(dJress)
PIDd~'/ 2uY7- 07 ~,)-O
(Phone).3Ze'7-34.s:-.. 5/7?1 _
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M4
(Phone) Z9- ~3/;- -_~77cJ
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(City) (Zip Code)
(Contact Person) (Phone)
APPLICANT SIGNATURE _~k -f!1:v DATE "7-/6 -~~d;:2
.- /"' .' l
APPLICANT PL ASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (l or 2 compartment sink
Shower Stall
Sinks REQU
Bar Sink EST FOR INSPECTION
Water Close :~pT TO CONTRACTOR. NO
ONSE - CLOSE FILE
Quantity
Type of Fixture
/
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
Industrial, Commercial & Multi-family 1 % of job cost with a ~j'J.JU mllll"'.....
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $ #"9' d- Building Penn it #
PLUMBING PERMIT FEE $ ;g q S-b
STATE SURCHARGE $ J , .50
TOTAL r J!.RMIT FEE $ H O.
(Office Use Only)
Building Official
Date
Paid t({),--
Dat~_{ ~-<J d-
ReceiPtf{'dS'B/
BYrr
This Application Becomes Your Building Permit When Approved
24 bour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714