HomeMy WebLinkAboutPlumbing Permit #06-0498
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Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 10-06
~i~ I PERMIT NO. ()I L::"_ L/O c>
,w Applicant g. L 7 9
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT !dp;LOCK J ADDITION
~ PI 5-395-0//).
(Phone)15=;) .~g~ ~l 09_
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(Address) <:.
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t\1 ui N)y\ ll) \ 9- tDllll
(City) (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 Water Heater
Floor Drain 1 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 $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.-39,50
'_ .50
/11) ./)(')
,
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
90
Building Official
Date
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