HomeMy WebLinkAboutPlg Permit 02-1275
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
/ u- 0 07--
1. Blue File PERMIT NO'O/_.-j ?1'/-~
2 Gold City ". V ~
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS
/7 33'0
ZONING (office use)
D/Z ~ 121.1>
~F
/)/2
LEGAL DESCRIPTION (office use only)
ADDITION
PID
BLOCK
LOT
OWNER
(Name)
(Phone)
(Address)
APPLICA~.-r- /' ~./ ../ /"
(Name) ~/. l J 11 c> t~ I/-I't,/kf? ~u._o;:;;_ (Phone) '7 /~
(Address) ~'7~;z~ Pn,4 /':L-~~/ <-.
(A dress) (City)
(Contact Person) ~ (Phone)
APPLICANTSIGNA~UR~__ ~ S:~.'? DATE /~- ~"'~{':>7 --
/ AP~LICANT PLEASE C~PLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
~~~:~; S~ REQUEST FOR INSP~~TION
Sinks SENT TO CONTRACTOR. NO
B S. k RESPONSE - CLOSE FILE
ar In MAY 2003
Water Clc
~96 ~6b7
fib I~
(Zip Code)
Type of Fixture
Quantity
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
J
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
$99.50
$39.50
Residential, New One & Two-Family
Residential, Additions & Alterations
Building Permit # (J 7- -/1.- 7 S
:J 7-- 50
11_. .50
c.r u .--CA--'
Estimated Cost $
$
$
$
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
Thi, APPI~' You, BuIlding pei~~ ~~:n .;:roVed
Building Official Date
Receipt No. /
4-JO,..,'
Dyer,
pai~ ~U V
Datq 0 I I
l ~'-f- 6 L-
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714