HomeMy WebLinkAboutPLUMBING 06-1065
CITY OF PRIOR LAKE PLUMBING PERMIT
FILE CLOSED DUE
TO INACTIVITY
Sent Letter
JULY 10,2008
Date Rec'd
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I ADDRESS
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. Blue File
Gold City
. Yenow Applicant
I PERMIT NO. (P. / () fr; 5 I
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
IOWNER
(Name)
(Address)
(Phone)
APPLICANT j I JI J I
(Name) ~/IJMm 1'/1lH1/)~Hf
(Address) 290) ~/,(j,/d 4(, S
(Address)
MAh
I
(Phone) @/~ ~Z7-'1lJ3' ~
/) S-'I01
(City) (Zip Code)
(Phone)
(Contact Person)
"PLICANT SIGNATURE
DATE
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher J Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall Backtlow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
APPLICANT PLEASE COMPLETE BELOW
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $ '1tJO
Building Permit #
(Office Use Only)
~his Application Becomes Your Building Permit When Approved
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.50
J.I (). aJ
Paid
Re IPtNO'suf/
Building Official
Date
Date J ( .
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714