HomeMy WebLinkAboutPlg Permit 02-0966
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File
2. Gold City
J. Y _lIow Applicant
I PERMIT NOi?~ - 1'10,
ZONLcoffice use)
/G/
- ,
(Please type or print and sign at bottom)
ADDRESS
j ';:J. 7>{ ~EF'Fetl)
fir ss
LEGAL DESCRIPTION (office use only)
LOT ;)l)3LOCK L1 ADDITION
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fP/liA-r
PID/l.5" 3t/P 013-(lf
OWNER
(Name)
(Phone)
(Address)
(Address)
(Contact Person) Olrff JfJo4
APPLICANT SIGNATURE 7// J~4
/
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 corr
Shower Stall REQUEST FOR INSPECTION
Sinks SENT TO CONTRACTOR. NO
Bar Sink RESPONSE - CLOSE FILE
Water Closet (Toilet)
~~~;~~~OfJ/lf 4c!1Jofll tJAjf"t2- ~r/)fl'121~Phone) 7t, 3-.) 3'1 -;2~;21
(Address) /6"3"3(:, ;2 997J, ,lfVf PtZf.;{&~
(City) (Zip Code)
7&3-;2/10 -0 JYY
DATE 2"-- 7-0 ?-
~ ~ '37/
(Phone)
/11
Quantity
Type of Fixture
~
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
age Ejector
dlow Assembly
dlow Assembly Test
n Sprinkler
~r
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 #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.50
Lfn. ----
(Office Use Only)
Building Official
Date
Paid
LlOr -
Date ~,...{ __ d-
Receipt Nt! 0-. 1/1
By q~&
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245