HomeMy WebLinkAboutPlumbing Permit #07-0029
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CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
117.07
I. Blue File PERMIT NO
2 Gold City .0-7 00,7
3 Yellow Applicant - L--
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ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID 2--:;- (/0 z.. oslo 0
OWNER \l:(' Q "'\ - 'tl..-
(Name) \ t:tv) ~\')'\ \
WfDY
(Address)
(Phone) g5~-~D{) . L/g')O
65?J1d...
(Address)
(Phone)
(Contact Person)
(Phone)
APPLICANT SIGNATURE
DATE
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
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 0 0 V
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
-,q. c; 0
.50
t..J U t 00
(Office lJse Only)
This Application Becomes Your Building Permit When Approved
Paid
4-0.00
i_ 17. u
Receipt NO_5 Z--!3 Z
By;(!
Date
#..
Building Official
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