HomeMy WebLinkAboutPlumbing Permit #07-0443
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Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(, . 4-~ 0 1
~.:~ ~:~ I PERMIT NO. 0: 044<3 [
3. Yellow Applicant , /~
Please type or print and sign at bottom)
ADDRESS
3-:S<Oo :S~~ut.L L'-'L\.t-.. ~<AJ
ZONING (office
use)
~r tOr Lc.U-~
LOT
BLOCK
ADDITION
PID zG: 172-. 03/, 0
I
]
LEGAL DESCRIPTION (office use only)
OWNER.......-
(Name) ~(.) ~
~ L.\5Cl
~\'-J C"d
(Phone)
(Address) ""S
APPLI~.
(Name) X
(Address) _~ 0.. ~
(Address)
~~\~
(Phone) g)"d-- 41d-- /137
~CAJL
(Contact Person) C ( ~ '"'-
cc ~ \ \Jr--.J
(City) (Zip Code)
(Phone) ~ S-a- L-t '--'.0- S-,"'") S
Quanti
T e of Fixture
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavator Bathroom Sink)
Laund Tra (lor 2 com artment sink
Shower Stall
Sinks
Bar Sink
Water Closet
\
APPLICANT SIGNATURE
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 $ /-cg Db. ~ Building Permit #
PLUMBING PERMIT FEE $ ~ ~. 5"'0
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $ '-\.0 . 0(,)
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Date
Paid -10.. VV
Date(b. f~ r/
Receipt No.
Building Official
By
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714