HomeMy WebLinkAboutPLUMBING 06-0976
Date Rec'd
(Please type ,
ADDRESS
CITY OF PRIOR LAKE PLUMBING PERMIT
FIIJE CLOSED DUE
TO INACTIVITY
Sent Letter
JULY] 0, 2008
L Blue File
2. Gold City
3. Yellow Applicant
PERMIT NO. do - 97~
ZONING (office use)
3M
1o/Lfla.l!J ~~4fJ"/
LEGAL DESCRLt'TlON (office use only)
LOT
BLOCK
ADDITION
PIQ)5- /55 J()d-b-,'-O
OWNER /) J /
(Name) ruA1 vvJ,(
(Address) f/~2~1' _fMt'! i'De"~""fl
~~;~~AN~/'", ~ (Phone)
(Address) 2&Jr' ~" /w.#fdtJ.kr'J;
(Address) (City)
(Contact Person) trJ /1 (Phone)
PPLICANT SIGNATURE /\VL P-- . DATE
- r;r APPLICANT PLEASE COMPLETE BELOW '
Quantity Type of Fixture Quantity I
Bath Tub with or without shower Rough-ins
Dishwasher I 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
(Phone)
tll;%1?-J/~/~
r.rp~J'
(Zip Code)
,~A'I/t;(,
,
Type of Fixture
FEE SCHEDULE
Industrial, Commercial & Multi-family I % of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ \SC?,SD
$ .50
$ If(/, O/J
(Office lJse Only)
Building Official
Date
Paid /10 .
Dati t) h ().. -; - (0
R~#4<E!
Bye.
C~r'
This Application Be(:omes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714