HomeMy WebLinkAboutPlumbing Permit #07-0438
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Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
~. ~~ ~:;y I PERMIT NO'O-?_A :!' e"
3 Yellow Applicant , -1- ~.::r;:J
ZONING (office use)
/~OS-'6
/'V\ " I"
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
Ale-Is 0 N
(Phone)
f/r ,'0
(Address)
APPLICANT
(Name)
S'?'( ht e
(Phone)
(Address)
(Address)
(City)
(Zip Code)
APPLICANT SIGNATURE
(Phone)
(Contact Person)
DATE c.- - ,;/-c;?
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
I Shower Stall "- e e{ " Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
FEE SCHEDULE
Industrial, Commercial & Multi-family I % of job cost with a $39.50 minimum
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Permit #
$ ~l"C;;-o
$ .50
$ 40. -
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Date
Becomes Your Building Permit When Approved Paid
(-
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714