HomeMy WebLinkAboutPlumbing Permit #07-0385
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CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
5.2-3.07
; ~~ ~:~ I PERMIT NO. ()"7, 038r.::-1
3. Yellow Applicant .-.-J ,
I~~~~~~:::
ZONING (office use)
~E
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PIDZ.S'"". 23Cj. 012...0
~~e~RDu'SstlV\L ~(i e.x-
(Address) ~n\SL \
(Phone) gCJ~ .)3 ~- 02'3D
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APPLIC~NT ' '1.~ Jr 'Y/l r :
(Name)~(}l()n (AJUAU ~ vi LeJS
(Address) J I ~ t\I R i Vet' ie; dry. Cr .
(Address)
APPLICANT SIGNATURE
(Phone) Et)~ -1?jp- ~9Cf-{
l'1v, \~ C.::[3 3~1
(City) (Zip Code)
(Phone) ~ -1'3> b j~)9 oi
"3 -;
DATE
(Contact Person)
APPLICANT PLEASE C
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher I 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 $ :J () 0 ' <iJ
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.3 C1- CJo
.50
L( 0 . 00
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Date
Paid Li..<-, .
-, v. 0 V
DateS. 23" G
Receipt No.
Building Official
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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