HomeMy WebLinkAboutPlg Permit 02-1446
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
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I, Blue File PERMIT NO
2 Gold City '/'1 '1-/4" J /)
3. Yellow Applicant ( /r;x '1 E::
(?Ji2) ZONING (office use)
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(Please type or print and sign at bottom)
ADDRESS
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LEGAL DESCRIPTION (office use only)
ADDITION
OWNER
(Name)
(Address)
APPLICANT
(Name)
(Address)
BLOCK
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0U/:,J".IGAN WATER CONDITiONING
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MINNETONKA, MN 55345
(A~) 933-72UU
(Phone)
(City)
(Zip Code)
(Phone)
(Contact Person)
APPLICANT SIGNATURE~'lliI~ & -f)Jf M
Quantity
DATE
IO!I,!02
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
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L, REQUEST FOR INSPECTION
st SENT TO CONTRACTOR. NO
Si RESPONSE - CLOSE FILE
Bl MAY 2003
Type of Fixture
W <ow_ ~.~~_.,. _u_./
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1 % of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $ 200. 00_
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
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.50
40. DO
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid / //1 o1J Receipt No. ,/
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Date O~~By
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
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