HomeMy WebLinkAboutPlg Permit 02-1352
Date Rcc'd
CITY OF PRIOR LAKE PLUMBING PERMIT
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I Bille File PERMIT NO. .." ") ___I ") f . "t'l
2 Gold City ./..
., Yellow Applicant /) (;1. '") _)<~ -
ADDRESS r-. q
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~h d {j eli oaJJh Ci (( I e 1St..
ZONING (omce lIse)
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LEGAL DESCRIPTION (office use only)
LOT (1 BLOCK I ADDItION
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OWNER
(Name)
(:1 " ( ) I T( 0 bet -t
fJ102- t-hd (1 en
(Phone) (qD)] ) LI ,/ 0 ~ l{? q /jJ
(Address)
{)(ltS Circl{~ Sf.
(Phone) ({j'IZ) <[5'21 ~ L{ 0,3;
I (Y)OI S. ' 5fj-IOt
"' (City)
(Zip Code)
1~:~~ ~ANT t\1 u r ~} / () rn F' ( u rn f;,t lLl
(Address) 2-[(0 'J f701 fl/ I r1 --1y. j50 .
(Address)
(Contact Person) \Jft( ~li.2J ~)J on "}
1\ "?PLIcAr~TSIGNATU~? !~11't~
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APPLICANT PLEASE COMPLETE BELOW
Type of Fixture I Quantity
Bath Tub with or without shower I
I Dishwasher I
u1 Floor Drain I
I Lavatory (Bathroom Sink) I
I Laundry Tray (lor 2 REQUEST FO'R INSPECTION
I S~lower Stall SENT TO CONTRACTOR. NO
I Stnks. RESPONSE - CLOSE FILE
I Bar Smk MAY 2003
I Water Closet (Toilet
(Phone)
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DATE ID/5/ IV J/'
Quantity
Type of Fixture
Rough-ins
I Water Heater
I Water Softner
I Stand Pipe (Washing Machine)
, Sewage Ejector
Backtlow Assembly
Backtlow Assembly Test
Lawn Sprinkler
Other I
FEE SCHEDULE
Industrial. Commcrcial & Multi-family 1% ofjoh cost with a $39.50 minimum
Rcsidcntial. Ncw One '*- Two-Family $99.50
Rcsidential, Additions & Altcrations $39.50
Estimated Cost $
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Building Permit #
PLUMBING PERMIT FEE $
STA TE SURCHARGE $
TOTAL PERMIT FEE $
~~q . 5~_
.50
LID. OIL
.' .iOffice lIse Only)
(,_~)hiS Application Becomes Your Building Permit When Approved
Paid
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Receipt No. '. / ;--
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By .
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Building Official
Date
Date . I
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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