HomeMy WebLinkAboutPlumbing Permit #07-0101
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Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
3~.o7
~.:~ ~:~ I PERMIT NO. 0'1. o' "0' I ( I
3 Yellow Applicant ~ ~ ~
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
'f)obart- 6i } ber t-
(Phone) q'5;? - Lf4'7 - Ca3l1 7
(Address
~;;~~ANT ffp R'jQf V'/lJ(Jc S.
(Address) 3070 ' J2Jei d f-d.
(Address)
,'5'O;~
(Contact Person)
(Phone) lfJ 1- 3(~J~.' j _~I 0
q~an J1N ~~! ~ol)
(Phone) ttT5t' .Jb ~ /3Lfo
DATE j. J 1<-0
APPLICANT SIGNATURE
APPLICANT PLEASE COMPLETE BELOW
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 $ () 0() . 00
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
Jq .?tJ
.50
4-0 - 00
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid 4-0 ,O'V
Date..., .-
::>~.O
G 1/07 f>
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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