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Plumbing Permit #12-384
� ❑❑�, c� o❑oaa❑ � o a Z� n ��, o o p 3��u�,�° z � �o "' o G y � ��� 3 m �c3z-� Z � v �'n � � m m N � T 1 y �z�z � y O v �t � � D Z � ���'� Z� ro , � � u c� � z r z� � � �� � o � o ?� _ � _ .� n x m � O � Z � �( � � r p � _ �1 � 'O '20 Z � A � ❑�0❑�❑ `�� m m m m ��ou,�;� � � � y O O n C � n C S3�RIS3 � n f/1 � c � � � Z G�i = O p O�G = i 3 = m � � o z r Z�C 7�C � Z � C � Z � � ��� � C � A � = m O C � � n � y m �(O❑OO❑ N y � ����L� m � � � G =���� 1_ � Z mnnsv � c> >_mm=� � m c ���-�p 1 � �� r m '"�'i � 04 PR[p� Date Rec'd' F CITY OF PRIOR LAKE PLUMBING PERNIIT J � ��vnrss�� � . , . i: � � PERMIT NO. /Z 3 �„ ], Yelbw Apqk.w / CiiC Ot t etld et.�WL[Om ADDRESS � � ZONING �ore« �� � LEGAL DESCRIP'1'ION (oE6oe �ue only) , LOT BLOCK ADDITTON PID OWNER � (Name) (Phone) � - o8- �a (Address) �� Appiiance Cnnnections nc � 1 ano a r �hone) twaar�) - opee, cclty, cz�p c�� (ContactPecson) g ' (Phone) APPLICANT SIGNATURE `6I� DpTE APPLICANT PLEASE COMPLETE BELOW uantl of Fixture uxnH of Fixture Bath 'ltib with o� without showcr Rou h-ins Dis6washer Water Heater Floor Drain Water SoRener Lavato athroom Sink Stand Pi e ashin Machine Laun Tra 1 or 2 co artment sink Sewa e E'ector Shower Stall Backflow Assembl Sinks Backtlow Assembl Test Bar Sink Lawn S rinkier Water Closet oilet pther FEESCHEDULE • Industrial, Commercial & Muld-family l Ys of job coet with a 549.50 minimum Residential, New One & Two-Family S 149.50 Residantial, Additio�a & Altoratio� 549.50 The Mi�nesota Statuks § 326B,148 ^� S Building Permit # "SURCHARGE' has been changed for one � l year effective PLUMBING PERMIT PEE S .lu�y 1, 2oto, antii �une 30, zo11, STATE SURCHARGE S. The minimno sorclar;e tor �"flied Ibe� p��t TpTAI. PERNIIT FEE S b $f. 6eEindleg�Jnly l. 2014 1'hb Appliestlon Becoma Xour Batldtng Permit When Approved Paid �¢ S = � Rece' o. �� 7 � . a�wi.. oma.i u,� '� 5 1 �r `L By • 24 6oar aodce for all ia�peettoai (952) 447A850, hz (952) 44'T-4245 46,46 DdcW� Street 3.E., Prbr Lalce, Mi.ridoh 55372 . '. � , • • � _ __..._.— • '�., ._ " . ' � . ' � ,• . .. � . � y .. �� . • . . �.�..� . �.��' �.�� . , A � � � . . .... . . ' � , . • • . � • ✓ . �. � ., . ' . . • . . : . , . ' � . . ' . . � . . . . . . .. . .... .. •� ... ... ....�..... .�. . ... � �: .. � .... . . . . . � ' � .. . . . .. . . . . �... . . • . .. . .. . .. . ., .... .. . . . _ .. ...�. ,... . ' t . . ... . . �-. �. .��. . t. � . . . . ...... . . ..... . - �' . .. . , . �.., . .... ... . . :�� � ..... ... . ...... .. . . _... .. _ . � .. . .. .. . �... . � . .. _... .. .. . � : :. �. , ...� ' . .. � . �� �. .. .•.. , . . . . . ' � _. . . .. . .. . .. . . . . . - . � �1 . . • ' � .'� . ...... ... � . . . : , . . .. . .. .. . . � � ' ... . . . . . . .� �. . . . . . . . .. . . � . ` . . . \ �... .. . . . .. . .. • . , . . ..._ ' . . . . . � , j� ` . . . . ..... .. . � . ` . } � 1. ' .� ' . �