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HomeMy WebLinkAboutPlumbing 99-1412 n. CN~.' ... ~.. Coo",. ( ,~ Applicant: Address: Signature: V Legal Description: Lot Block Sub Site Address:~.5L() j-\ A-V' Do ~ rvL 1\\':> - l..fo3-Cf'ty(~ auilding Permit # PID # -Z5 - 2.38 ..011- () NOTE: This permit will not be processed without complete information. CITY OF PRIOR LAKE PLUMBING PERMIT S/-l-anJtH Wlttev- c'o 73/ 1- (G0 4ue N vCJ &QU~ # Phone:-.G[G.~ '?S3 -Cj2~Y V 1. Blue File 2. Gold City 3'qq:(71i~ FIXTURE UNITS Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Floor Drain Lavatory (bathroom sink) Laundry Tray (1 or 2 compartment sink) Shower Stafl Sinks Bar Sink Water Closet (toilet) I I Rough-ins Water Heater Water Softner Stand Pipe (washing machine) Sewage Ejector Backflow Assembly (RPZ, Double Check, PVB) Backflow Assembly Test Lawn Sprinkler Other Dishwasher FEE SCHEDULE CLOSED DUE TO INACTIVITY 1/1/03 Industrial, Commercial & Mult (1 % of job cost, $39.50 minimum) Residential, New One & Two Family Residential, Additions & Alterations State Surcharge $99.50 $39.50 $ ~9. 5"D $ $ $ .50 GRAND TOTAL $ qo.o7) This permit is granted upon the express condition that said contractor, shall comply in all respects with the ordinances of the State Plumbi ~he amet;;me thereof. ..3'5PJlo . 12. I '1'1 DATE . } / ATTEST Call for all . 16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372/ Ph. (612) 447-4230/ FAX (612) 447-4245 An Equal Opportunity Employer