HomeMy WebLinkAboutPLMBG 06-0413
THIS FILE
CLOSED ~S BEEN
INACTIVr E TO
--1"'\~~ TY 4/18/2008
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(5 w 0'
LEGAL DESCRIPTION (office use only)
LOT /0 BLOCK I ADDITION
Date Rec'd
F PRIOR LAKE PLUMBING PERMIT
EQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 10-06
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~~~Iicant I PERMIT NO. ~ 0 - C/ I ~
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PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
/ f::> r PI~ - Itf3"' 010
(Phone)
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OWNER
(Name)
(Address)
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(Phone) tell- ~J) clo~,>
OZ:>
(Zip Code)
APPLICANT
(Name)
(Address)
(Contact Person)
APPLICANT SIGNATURE
(Phone)
DATE
oS- -/5"" -lJ{;
A PLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower . Rough-ins
Dishwasher 1\ 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 Lawn Sprinkler
Water Closet (Toilet) Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1 % of job cost with a $39.50 minimum
Estimated Cost $ ~
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Building Permit #
$
$
$
~so
.50
4000
Paid C( (), ---
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