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HomeMy WebLinkAboutPlumbing Permit 03-0740 CITY OF PRIOR LAKE PLUMBING PERMIT Date Rec'd ADDRESS ZONING (office use) (r-~ -3 ~. ~~~~ ~ilt: r PERMIT NO.O?~O-'AAI 3 Yellow Applicant _ I~UI , -5() 7'1 , L.UFr 1!13-/~/Il LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (Name) fJu /-IE 110 YJ1 LS 'OlllltuJ [~r (Phone) t,s"1-lIs2 -Sk;6 (Address) I\PPLICANT ~ ,. $.. (Name) AJ.(fJ K. t.. .. floS Address) j~ {)tJ. ~/lE It:I.Il?{ (Address) &J...lIn (Phone) ~~Z- 91.>- ~ 0cro/?t+ (City) (Zip Code) PPLICANT SIGNATURE (Phone) Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough-ins Dishwasher Water Heater Floor Drain Water Softner Lavatory (Bathroom Sink) Stand Pipe (Washing Machine) Laundry Tray (] or 2 compartment sink Sewage Ejector Shower Stall Backflow Assembly Sinks ~ Backflow Assembly Test Bar Sink V Lawn Sprinkler Water Closet (Toilet) Other -., APPLICANT PLEASE COMPLETE BELOW FEE SCHEDULE ldustrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum Residential, Nt Residential, Ac FILE CLC)SED DIJE TO INACTIVITY 1/4/2008 Estimated Cost $ Building Permit # PLUMBING PERMIT FEE $ STATE SURCHARGE $ TOTAL PERNUT FEE $ ?ft -0 ~) . .50 40 .... it hen Approved Pai110 , 0 0 Da~ J t. D J 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714