HomeMy WebLinkAboutPlumbing Permit #05-0017
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~ CITY OF PRIOR LAKE
:a ~8r ~BITIBlrUN8WI~v~1 ~.~t:eERBrT
Date Rec'd
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:ase type or print and sign at bottom)
1./~~"'7
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 01-06
Pink
Green
. Yellow
~!~. I PERMIT NO. /"fr 0017 I
Applicant V.....I .
ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT 2- BLOCK C ADDITION ORU-t/rtVP JS~ ~
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APPLICANT
(Name)
(Address)
(Contact Person)
(Phone)
DATE
RE REQUEST FOR FINAL
TYPE OF SYS' INSPECTION SENT TO
DWarmAirPlan HOMEOWNER 10-06
DGravity
o Mechanical U KaOlauon
DAir Conditioning 0 Special Devices
DVent. System 0 Other Devices
)WER PLANT
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Estimated Cost $
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Building Permit # () ~~ 0 017
$39.50
Industrial, Commercial & Multi-Family
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ J 7, .5{)
$ .50
$ 40. 00
(Office Use Only)
~his Application Becomes Your Building Permit When Approved
'lding Official
Date
Paid 4tJ. (IV
Date I. 11-, () S'"'"
Receipt N01f"~ Z J
By
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372