HomeMy WebLinkAboutPlumbing Permit #07-0594
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Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File
2. Gold City
3 Yellow Applicant
I PERMIT NO. 07 051#
ZONING (office use)
/\)orthwoods R-d NW
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID2~. \41 . OGtJ.... 0
OWNER
(Name)
i?JJ\I I ~(Ctd
Su
(Address)
APPLICANT t1 ' ,c.: '" ~ . "2 c::.. (?11
(Name) l ~4'Y1 pi 0 ~ \A JatPr ~ Y7 C~ $Phone) '=' "51- J ~ J-- u 1 0
(Address) ~~ N et\f-€. r Rld5-E:: Cr- ~'l \Le j-{rJ C:;C)'')rj
(Address) (City) (Zip Code)
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tf'
(Contact Person)
(Phone)
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APPLICANT SIGNATURE
DATE
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
I 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
I Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other eUA'1 ~aS I;~..e .-J!.tJr rC-lv
J
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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 $
ICOO I ()O
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
"f:)1:5 cJ ..J?f/ ,5"()
.50
I U U .. UU 41). c .;'
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid "'fC () D
Date7/.l (' 7
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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