HomeMy WebLinkAboutPlg permit 02-1163
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
9+~~
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~ANT SIGNATllRE ?? '/<J a
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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 compartment si
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
(Please type or print and sign at bottom)
ADDRESS
33S~
LEGAL DESCRIPTION (office use only)
LOT -; BLOCK Lj ADDITION
ewNER
(.e) Lv- &Alj,M4j'i~
(Address)
Quantity
I. Blue File PERMIT NO 3
2, Gold City . /1'"') .-. I' 11
3 Yellow Applicant l/t:::?" I II:?
ZONING (ottiee use)
IZ:3--SD
PIDdS.3b5-039-0
(Phone)
Ta", ~~7 6 '3 ,- 1/('1. ,,:< r- ,.2 l
p/l'~en~ ";-5-3 7 /
(_ 'tir,'~de)
(~ 76 j, .L,{b (// ,/,\-
..ltE 9-/5 (j 2
Type of Fixture
)(
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
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REQUEST FOR INSPECTION
SENT TO CONTRACTOR. NO
RESPONSE - CLOSE FILE
Ibly
lbly Test
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 $
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Building Permit #
39~O
.50
i{tJ ~-
",-,,(' )
, Paid '" .--
L/t) J ~
Date 4... /3-;}-
$
$
$
Rec~~~ 30
BY~
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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