HomeMy WebLinkAboutPlumbing Permit #06-1050
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CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
II. 1.,;(;.Ob
I. Blue File I PERMIT NO
2. Gold City . (, . 1050
3 Yellow Applicant .
I ~5;;;:Ud~~1U
ZONING (office use)
AJ!s a (~~
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
(Address)
(Phone)~4-~~'''7-c?;;2. "77
~
APPLICA
(Name)
(Address) [).j:;z..
(Contact Person)
;I l6t!e/?
(Address)
a~h ~-
y
e
~4~7
,
(Phone) C?S-:7- 43 <)"-'7 R" '//3
I'fIIP/l)S t//4..e- /J1fi/ _S-:';-33
(City) (Zip Code)
(Phone) q~ 'f;/:3. <r-/,gr(.jt!J
DATE -- '6'...-
.PPLICANT SIGNATURE
APPLICANT PLEASE COMPLETE BELOW
Quantity
Type of Fixture
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
Quantity Type of Fixture
Rough-ins
J l~ater Heater "5
I ~aL"'l
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
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOT AL PERMIT FEE $
39.50
.50
+fJ. IN
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid .fa. (/l)
Date It z,.o, () "
.5u,(,
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714