HomeMy WebLinkAboutPlg Permit 02-1120
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(Please type or print and sign at bottom)
ADDRESS
3S)'t-/ I<"FCf tJ{ / {Jt?7S5
LOT
LEGAL DESCRIPTION (office use only)
ADDITION
BLOCK
OWNER f A /
(Name) Vv fM:> tvl q I? 11
(Address)
40 ttV(J 5
APPLICANT 1
(Name) 111ool'e r;/- 11 oor {/vuffr
(Address) / OJ 3 6 ~ C(q1 {", a ve n.
(Address)
(Contact Person) 0 a v.--e /11 () 0 r-e
:~PLICANT SIGNATURE U!' t.~ /);1 rOlz..
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I Quantity
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I Blue File I PERMIT NO
2 Gold City . I,? -' / j -~, . 0
3 Yellow Applicant ij ..... "t.,....-'
ZONING (office use)
PID ZC;-Ye&.. - 6 t 7 - ()
(Phone)
-r:/l /J/A-lUAL tA f
I YI('VI! (phone)
{JrtV1C f'+r?1"'I
(City)
5577/
(Zip Code)
(Phone)
76 -?-;;)?6' oj q s-
C; - 10- o?-
DATE
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray C ---" ___u____~_u ---< _'._L
I Shower Stall REQUEST FOR INSPECTION
Sinks SENT TO CONTRACTOR. NO
Bar Sink RESPONSE - CLOSE FILE
I Water Closet (l MAY 2003
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
Residential, New One & Two-Family $99.50
Residential. Additions & Alterations $39.50
Building Permit # (z.- - /i Z- 0
Estimated Cost $
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
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/y"hiS APPli.C. at. ion.. .Be.comes Your Building Permit When Approved
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Building Official Date
3. 1. ~-v
.50
4- () v..cj
Paid".. . _."
q G. {c'
Receipt.No. _ ..~.
q .-;~. (j c: /
I Date,_; ;. . ..
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I 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
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