HomeMy WebLinkAboutPlg Permit 02-1393
Date Rec'd
CITY OF P:\R LAKE PLUMBING PERMIT
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I. Blue File
2 Gold City
3 Yellow Applicant
PERMIT NO. OZ-/393
(Please type or print and sign at bottom)
ADDRESS
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CdlC Ie
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ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
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(Phone)
(Address)
APPLICANlAA f~~
(Name) /'/o,/(.,(, ~ ;V)o"flt wrr /l,f '-- (Phone) 763 r r'J 2.. '5..2. I
(Address) 'Ia 3J6 ~, ~ 7J. AtE fJf/.i,.)(eff;~ S-S-J 7/
(Address) (City) (Zip Code)
(Contact Person) n /rI f ;11 () ! 12 e ~ (Phone) 1 b S' - ;2 f' 6 - 0 I V)
APPLlCANTSIGN:TURE ~0'/)(j DATE 10-;2.2. -o,p
i' APPLI~A~T PLEASE COMPLETE BELOW
Type of Fixture I Quantity
Bath Tub ,";th "r ",;+h~,,+ n\..mH~~
Quantity
Type of Fixture
Dishwas
Floor Dl CLOSED WITH SF
LavatolJ BUILDING PERMIT
Laundry
Shower:
Sinks
Bar Sink
Water Closet (Toilet)
~
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 $
Building Permit # t)l. - (J 9 J
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
"3 1. ~'U
.50
4-~. 0 0
(Office Use Only)
This Appli~ti~ 'iomes Your Building Permit When Approved
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Building Official Date
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Date
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Receipt No. (p
~S }J/A
By -ute..
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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