HomeMy WebLinkAboutPlumbing Permit 04-1115
CITY OF PRIOR LAKE PLUMBING PERMIT
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 01-06
Date Rec'd
lease type or print and sign at bottom)
ADDRESS
~d(p~mE'110 ~Ol.t:l
~~: ~!~. I PERMITNO.O~- j'/6t
Yellow Applicant I J
ZONING (office use)
5S3~
LEGAL DESCRIPTION (office use only)
LOT BLOCK
ADDITION
OWNER
(Name) rYbr-y ~c:t('")
(Address)
APPLICANT
(Name)
6030 CUUIGAN WAY
MINNETONKA, MN 55345
(95~ 933- 7200
(Address)
(Phone)
(Address)
(City)
(Zip Code)
(Contact Person)
APPLICANT PLEASE COMPLE
Quantity Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (1 or 2 comoartment<:ink
Shower Stall
Sinks REQUEST FOR FINAL
Bar Sink INSPECTION SENT TO
Water Closet (Te HOMEOWNER 10-06
FEE SCHEDULE
Industrial. Commercial & Multi-family 1% of job cost with a $39.50 minimum Resident
Resident
DATE JO- (o-Ol.,f
APPLICANT SIGNA TUR
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
Estimated Cost $~~
Building Permit # _
FILE CLOSED DIJE
TO INACTIVITY
1/4/2008
ITice Use Only)
rhis Application Becomes Your Building Permit When Approved
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ ----3:i5o
$ .50
$ LJo.l'X)
Building Official
Date
Rece%tt%
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
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