HomeMy WebLinkAboutPlg Permit 02-0467
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Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
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APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (B~+'
Laundrv r. o~
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Rough~ins
Water Heater
Water Saftner
Stand Pipe (Washing Machine)
Sewage: ~ject<.r
Backfl~W AsfblY
I\.s bly Test
- REQUEST FOR INSPECTION Ilkl I'
SENT TO CONTRACTOR. NO .
RESPONSE - CLOSE FILE
(Please type or print and siltD at bottom)
ADDRESS VSl\yq ftAlAJYI mwdaw CAr
LEGAL DESCRIPTION (office use only)
LOT BLOCK
ADDITION
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(Address) \\0140 ~oct(f\fL vcth\
(Address)
OWNER
(Name)
(Address)
(Contact Person)
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APPLICANT SIGNATURE
. Quantity
1k)
1partment sink
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$- 2 ..() L-
~: ~~~ ~:~ I PERMIT NO. () '7 -tl~ 1
3. Yellow Applicant e,...
ZONING (ofticeuse)
PID
(Phone)
q~fI1-441-SQ II
(Phone) C{Sf))-4?Jq/~11 0
((1Y1 :U,;UQ bb~11-
(City) (Zip Code)
(Phone)
DATE
1;( d 01....
Type of Fixture
~ & Multi-family 1% of job cost with a $39.50 minimum KCSlw"",,__, ~{)ne k Two-Family $99.50
Residential, Allditions ," Alterations $39.50
Estimated Cost $ /~?f11 Building Permit # 0 l,., -0 ~ 7
PLUMBINGPERMITFEE $ 39. Sp
STATE SURCHARGE $ 1.5 I)
TOTAL PERMIT FEE $ 4'() . (JQ_
Inc.
(Office Use Only)
This APplica". ~. O.JL; es Your Building Permit When Approved
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Building omCial . Date
Paid 4-0 i/b.
Date
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By~
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24 hour notice for all inspections (952) 447-9850, fax (952) 447...,2~5
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