HomeMy WebLinkAboutPLUMBING 08-0913
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Date Rec'd
~PRIOR LAKE PLUMBING PERMIT
(/ '?() AI/,' / J/C.~ '.
O.~ IVvV.~~ .)
~ I. Blue File
____ 2. Gold City
"""--- 3. Yellow Applicant
/o,30,Ob
ADDRESS
(p 4-~ 0
I.5>O?1!
Sf
I PERMIT N008 .Or/~
I
ZONING (office use)
---....-
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID 26:1 t6
OWNER
(Name) /3~t1IN
,
Lr/WU;Jt/t!k7/ CR/UF.t-y'J
/
(Phone)
4+7~ ~43
(Address)
APPLICANT /) ( 1~;'
(Name) tbt/t-'l /Tl,,,
(Address) .3~y L, ~~ CO//\!
(Address)
(Contact Person) &'E
~L
A1/Y~
11/
(Phone) 9s;;;... c::;:7j ^ I Ji' / f,.
~ jl,4~ .5~" 7/
(City) V' (Zip Code)
APPLICANT SIGNA TV
(Phone)
DATE
Quanti
APPLICANT PLEASE COMPLETE BELOW
T e of Fixture Quantit
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatorv Bathroom Sink
Laund Tra 1 or 2 com artment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
e of Fixture
FEE SCHEDULE
Industrial, Commercial & Multi-family 1 % of job cost with a $49.50 minimum Residential, New One & Two-Family $149.50
Residential, Additions & Alterations $49.50
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
+9, SlJ
.50
SO,OO
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid L7J . 0
.-:;U. ()
Rfe~;iPt No~-z, 9 ?
Buildin!! Official
Date