HomeMy WebLinkAboutPlg Permit 02-1332
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File PERMIT NO ....,-,',
2 Gold City ./~Jl_ /1- '),'~
3 Yellow Applicant ...... '::1" -~'..
(Please type or print and sign at bottom)
ADDRESS
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ZONING (office use)
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(Address)
(Contact Person) r1 F0d ~l
APPLICANT SIGNATURE
LEGAL DESCRIPTION (office use only)
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LOT ,;2BLOCK
I ADDITION
PID ,?-5- ~ ,(jO-O (),')-h
OWNER
(Name)
(Phone)
<i081-~ql-11:i0Y
(Address)
LLU10
(Address)
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(Phone) {~0.~-~15 / '/)'710
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(City) (Zip Code)
(Phone) C1S.~ ,q~s- 77l C'
DATE
Quantity
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink ~
Shower StaB ~SY"Ecr\O ~O
Sinks S'{ VOR \ C'{OR.
Bar Sink ~Q\J"E 0 CO~'{~S"E V\\.J"E
Water Closet (Toilet) S"E~'{ '{ ~S"E _ CLO
~SYO
~~ ~CHEDULE
Industrial, Commercial & Multi-family 1% of job l."~{ with a $39.50 minimum
Type of Fixture
Rough-ins
Water Heater
Water Softner
and Pipe (Washing Machine)
wage Ejector
~kflow Assembly
kflow Assembly Test
n Sprinkler
~ .1Ier
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
,?) Cj, 5--0
.50
L/CJ ,-
,
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
'Paid L(O.,----- . Recet/'Jf~~
Date/, //J -(J --r- By 1_)_ ./
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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