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HomeMy WebLinkAboutPlumbing Permit 03-0738 CITY OF PRIOR LAKE PLUMBING PERMIT Date Rec'd (p . 9, D} I, Blue File I PERMIT NO I 2. Gold City . /). ? -0' -,;> B 3 Yellow Applicant , U',,-, t..J ZONING (office use) pun BLvPr If7T TJtA.-. LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID2.5 - 9fJZ- -vat ,[) 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).-);')) :-h4 J., /1 (City) (Phone) "1'")). - 'f:'{.) )0 I DATE &, - 9-os '5"Y 3S.) (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) paiw, VU Date ~/1 'his Applic~o:~~es Your Building Permit When Approved /tf/YJ &. q,cJ] 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