HomeMy WebLinkAboutLawn Sprinkler Permit #07-0771
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DaC:e Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
Y~(.5_fi 7
I. Blue File
2. Gold City
3. Yellow Applicant
I PERMIT NO. 07. 017 I I
ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name) Ijritu:- JdAJ(j,
(Address) r~1M,./
(Phone) 9.r~-l'/r7-IJ"7
APPLICANT _ . r
(N ame) -y;;, "'d f f j v...JJ ') -r<f ~,
(Address) ,173( -aa.Y\J~ /-I"."
(Address)
(Contact Person) ...-, c-L
(Phone) 7.( j ~drd - -r~F
/1......4 /J1..-"'" .rne;-;
(City) (Zip Code)
(Phone) 7,tl~ .f6t:?-/Id.S-
APPLICANT SIGNATURE
DATE
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 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 #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
3950
.50
4O.c0
o. 54'5'1-/
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid +0. CO
Date 8- 6~ cJ
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714