HomeMy WebLinkAboutPlumbing Permit #04-1009
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CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
/v.f.R.04-
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 01-06
LTrq " J
File
City
Applicant
I PERMIT NO. rYI' . / 001 I
I
ZONING (office use)
21,,,, """ '" print......." botto~
I ADDRESS
3::5)(J) j Fox Cl i
553f)@
LEGAL DESCRIPTION (office use only)
LOT 1,. BLOCK ( ADDITION W I '-OS (P'111
PID.2.5"". 4(2. d () Z. . 0
I OWNER
::S) I~~~TJ~K
~~J~-(D~
APPLICANT
(Name)
(Address)
NQITIONING
6030 CUltlGAN WAY
MINNETqNKA. MN 55345
. (952) Qa3. 7200
(Address)
(Phone)
(City)
(Zip Code)
(Contact Person)
APPLICANT PLEASE COMPLE
Quantity Type of Fixture Quanti
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (1 or ~ N AL
Shower Stall REQUEST FOR FI
Sinks, INSPECTION SENT TO
Bar Smk OWNER 10-06
Water Closet (Toile ROME
ELOW
APPLICANT SIGNATUR
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
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
B::)O 00
Estimated Cost $ .
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
'--~ .g)
.50
LJO .CO
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid 4-0. (/l)
Date /0. (p~O I-
Receipt N'il1 g ~7
By
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714