HomeMy WebLinkAboutPlg Permit 02-1074
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
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3 Yellow Applicant , Ll_ /~
ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT d- LOCK / ADDITION
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PID 5- 3 70.-0~'-I-
OWNER
(Name)
(Phone)
lJ!31-~<S - 2XLl,
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APPLICANT e~\I...A<tn ~
(Name) ~v,1
(Address) \ (014'0 1{ ~J a 'Utnf\
(Address)
(Address)
(Contact Person)
(Phone) ~S~-lJd?h-?JJ}O
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(City) (Zip Code)
(Phone) qS-o j-r~~~ 17D
DATE '61)f;7 () 'L-
APPLICANT SIGNATURE
f nnT U' A NT PI .1fASF. COMPLETE BELOW
Quantity TYPI Type of Fixture
Bath Tub with or' REQUEST FOR INSPECTION Rough-ins
Dishwasher SENT TO CONTRACTOR. NO Water Heater
Floor Drain RESPONSE - CLOSE FILE I Water Softner
Lavatory (Bathroc Stand Pipe (Washing Machine)
Laundry Tray (1 or 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
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 $
Building Permit #
3q ,sf)
.50
~6 ,--
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid tf 0 r ---
Date
,<9-0- d-
Recei~~r~ 00
By
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave" S.E., Prior Lake, MN 55372-1714