HomeMy WebLinkAboutPlumbing Permit 07-0082
CITY OF PRIOR LAKE PLUMBING PERMIT
CLOSE THE FILE
DUE TO INACTIVITY
2/10/2009
Date Rec'd
2-/2-,-/e5l
(Please type or Print and silm at bottom',
ADDRESS! fI 'Z 2/
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I. Blue File
2. Gold City
3. YeUow Applicant
PERMIT NO. 07 - (j() f72.-
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ZONING (ofliceuse)
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID 2'5'- , l '1 -0" ~ - 0
OWNER
(Name)
(Address) 1 tJ 3z f
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(Phone)
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APPLICANTj 1
(Name) I/Akf-- tOt/Iltl7U1
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(Address) p.O. &X 3D
(Address)
(Contact Person) ~ s: ~tf~
APPLICANT SIGNATURE (- I-~ _
,Pkf/rnButb.' lR./{'( (Phone) (of~) i)q7-S-r.>o
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(City) (Zip Code)
(Phone) /er I,)) t;y 7- tt' \n
D~TE/ ~/~//07
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APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity I Type of Fixture
Bath Tub with or without shower i Rough-ins
I Dishwasher I Water Heater
I Floor Drain I Water Softner
I Lavatory (Bathroom Sink) I Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 compartment sink I Sewage Ejector
I Shower Stall I Backflow Assembly
I Sinks I Backflow Assembly Test
I Bar Sink I Lawn Sprinkler
I Water Closet (Toilet) I Other
Quantity
/
/
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 $
Building Permit #
(Office Use Only)
This Application Becomes Your Building Permit When Approved
~ ~ z/z, 1,/0 7
Building Officia1 date
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
31.S-0
. .50
'dO.O 0
Paid....
'9 ~O.o 0
Date I I
2 '2...1.. fr}
Re~~b 7
BY~.
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave" S.E., Prior Lake, MN 55372-1714