HomeMy WebLinkAboutPlumbing #06-1027
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CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
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I. Blue File
2 Gold City
3_ Yellow Applicant
I PERMIT NO.cp ./oz 71
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ZONING (office use)
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LEGAL DESCRIPTION (office use only)
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ADDITION
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OWNER
(Name) ~
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(Phone)
(Address)
APPLICAN~/ . J J /)} J,
(Name) /1/(J/lJh#1 r li"IfO/~ .
(Address) Z905 hrJ:;/J IIPt S
(Address)
(Phone)
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City)
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(Zip Code)
(Contact Person)
(Phone)
DATE
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 $ 1/00
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOT AL PERMIT FEE $
'39. 10
.50
I{0.00
(Office llse Only)
Building Official
Date
This Application 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