HomeMy WebLinkAboutPlumbing Permit 03-0738
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
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I, Blue File I PERMIT NO I
2. Gold City . /). ? -0' -,;> B
3 Yellow Applicant , U',,-, t..J
ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
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OWNER
(Name)
(Phone)
(Address)
<\PPLICANT j. ,. [)'
(Name) \h I, Ctj \ 1\).'1'\ \?nC1
Address) 'E>L. () (1v!~ kl..t-'" A v t. .
(Address)
20ntact Person) Ofl Ai r/!orr"5
.PPLICANT SIGNA TURE <::7~ ;:$2.:... /
(Phone) (IS~.)" </9).-);'))
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(City)
(Phone) "1'")). - 'f:'{.) )0 I
DATE &, - 9-os
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(Zip Code)
APPLICANT PLEASE COMPLETE BELOW
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 (lor 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks , Backflow Assembly Test
Bar Sink ;x. Lawr
Water Closet (Toilet) Othe FILE CLOSED DIJE
FEE SCHEDULE
ldustrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum Residential
Residential,
T() INACTIVITY
1/4/2008
Estimated Cost $
Building Permit # OJ - 0 7:18
39.57)
.50
+O.UD
$
$
$
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
ice Use Only)
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Date
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'his Applic~o:~~es Your Building Permit When Approved
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Building Official Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714