HomeMy WebLinkAboutPlg Permit 02-0634
CITY OF PRIOR LAKE
PLUMBING PERMIT
1. Blue
2. Gold
3. Yellow
File
City
Applicant
# o~- h3'f
Th. C.nl., of lh. Lake Counlry
Applicant: \\MS GUCLll~ t'\l.U"Y\Io\Y\<j Phone: (Cfl?~)e.ac;.'~u?.q
Address: tjc;>.~ Ux1tra..\ ~V(.. 0st;LD f'(tJ t::Jt;~~
Signature: ~ dI.fj.JJ~'YOV _
Legal Description: Lot J If Block J Sub dab ~1I.p JIJ1~
.
Site Address: ~~l~ e,C/.V)d\{ t1JVP \V'aA 1
Building Permit # PID #dS- t) 55"- () I q-o
NOTE: This permit will not be processed without complete information.
FIXTURE UNITS
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher \ Water Heater
Floor Drain Water Softner
Lavatory (bathroom sink) Stand Pipe (washing machine)
Laundry Tray (1 or 2 compartment sink) Sewage Ejector
Shower Stall Backflow Assembly (RPZ, Double Check, PVB)
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (toilet) Other
REQUEST FOR INSPECTION
SENT TO HOMEOWNER. NO
RESPONSE - CLOSE FILE
Industrial, Commercial & Multi 4/2003
(1 % of job cost, $39.50 minimum)
FEE SCHEDULE
Residential, New One & Two Family
Residential, Additions & Alterations
State Surcharge
$99.50
$39.50
$
$
$ ~.C;O
$ .50
GRAND TOTAL
$ 4:0.00
This permit is granted upon the express condition that said
contractor, shall comply in all respects with the ordinances
of the State Plumbing Code and the amendments thereof.
lJ~;).t) RECEIPT NO, ....5 - BI ~ DATE
~~ ATrnST
Call for 1 inspections 24 hours in advance.
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230/ FAX (612) 447-4245
An Equal Opportunity Employer