HomeMy WebLinkAboutPlumbing Permit #07-0182
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Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
4-. 4 . (/7
I. Blue File I PERMIT NO
2. Gold City . -1. Ie z,
3 Yellow Applicant I
ZONING (office use)
g33f).
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER .
(Name)~~ -rc-~, Ken
(Address) d I "'hnS
APPLICANT
(Name)
(Address)
CULUGAN WATER CONDITIONING
6030 CULLIGAN WAy
MINNETONKA, MN 55345
(Address) (952) 933-7200
(Phone)
(City)
(Zip Code)
JPLICANT SIGNATU
.31 rJ/ /o?
(Contact Person)
Quantity
APPLICANT PLEASE COMPLET
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
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
$~
$ .50
$ Llo.CYJ
(Office Use Only)
'his Application Becomes Your Building Permit When Approved
Paid 40, (JU
Date
R7C7ipt NoS 3 2-? tr-
B
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447:..t245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714