HomeMy WebLinkAboutPlumbing Permit #06-0494
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CITY OF PRIOR LAKE PLUMBING PERMIT
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 10-06
I ~=~~d'~Mbo~m)
. 21ff1 TiYn~---YL{--C:C/' /
Date Rec'd
. Blue File
Gold City
Yellow Applicant
I PERMIT NO. ufo -- LlCf4"
I
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT (() BLOCK :< ADDmON
~-O/tf ()
(Address)
'{ L~-C.:B AI 7rlC-l~{!L---L-L/rtSPhOne)
7'1 ~ 'Tf'"
OWNER
(Name)
'\PPLICANT SIGNATURE
(phone) 952- 44D-317cr
ffllLh LLZJ:;e. ,-Lj"S37 7
(City) (Zip Code)
(Phone) .k XT 2/'5
~. DATE )
(Contact Person) ,
Quantity
APPLICANT PLEASE CO LETE BELOW
Type of Fixture Quan 'ty
Bath Tub with or without shower I
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
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 $ J?-:f.....~S ~ Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
3Ci ~)
.50
40.0v
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Date
Paid 110......
Date ~ _ f? - 6
Rec2E.t No:.-c
~/Lo'/
By
Building Official
24 hour notice for all inspections (952) 447.9850, fax (952) 447-4245
16200 RlIolp C"rpplc Avp_ S:.F... Prinr T.lIlcp. MN ""'177.171<1