HomeMy WebLinkAboutPlg Permit 02-1451
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(Please type or print and sign at bottom)
ADDRESS
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LEGAL DESCRIPTION (office use only)
I. Blue File I PERMIT NO 51/
2. Gold City . A :..2-1' .I '-
J. Yellow Applicant ( .I~ '-7 J
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ZONING (office use)
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BLOCK
ADDITION
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APPLICANJ'1 _LL ~ I L-L /J - 7 .11/
(Name) (~rn{ll{i.rS Lf-JfI IA_rL(~_r ('J. (Phone)~q-d.S:J- 7u
(Address) {jj.5I)W 05V\J \.\erVW Dri Ve, Bia itJe- J 65LJ Lie;
(Addr~ (City)' (Zip Code)
(Contact Person) Krjs Hnh~,tA (Phone) 7~;:).. -77:( J
APPLICANT SIGNATURE ~M~. DATE JO-dC;-CF;}-
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APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartrr
Shower Stall REQUEST FOR INSPECTION
Sinks SENT TO CONTRACTOR. NO
Bar Sink RESPONSE - CLOSE FILE
Water Closet (Toilet)
(Phone)
IJ/-A
Quantity
Type of Fixture
x
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Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
ector
Assembly
Assembly Test
nkler
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 $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
',~9,SO
tft; .50
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(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid '10,00
Datell_I_O J-'
Receipt No. (}3 ~/
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BY~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245