HomeMy WebLinkAboutPlumbing Permit #12-0646 � ❑ ❑ C'� ❑ODOO❑ 'o O D zc�
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� YRlp Date Rec'd'
� � CTTY OF PRIOR LAKE PLUMBING PERMIT
U �
�vrvss�s • . . .
i a�`ae c""`�`sa �PERMIT NO.
a r.ua. eop�r r �
�te or aud asbotoom
ADD ' \ ZONIN(3 (ot�a we)
� � ly`�' 1/��
LEGAL DESCBIPTION (oESce nse onlr) .
LOT BLOCK ADDTTION PID
OWNER /1�
(Name) �1 (Phoae) ��.��CL� � p�
<Address)
APPLICANT �
�z•i�� A�olianc�Cnnnpctinng i�po,���.
cAa��� _ � 1313 Dan6ta Cr �
t �kopee, MN 55379 ��'�' `��
ceonracc Petson) tPhane)
APPLiCANT SIGNA � � DATS / 01
APPLICANT PLEASE COMPLETE BELOW
aanti of Fi=tore anf3 of F�inn
Bath 1�b with os without shower Ro -ins
Dishwasher � Water Heater �
Floor Drain Wator Softe,nea
Lavato m Sink Sfsad ' ashi Machine
i.a Tra i or 2 o- t sink B'ector
Shower Stall BacJ�low As�embl
Sinks Backflow Assemb Test
� Bar Siak I.awn ' es
Water Closet oilet ' Other
FE8 SCE�DULE .
I�dusuial, Commciccial 8 Muld-family IYo of job oost with a 549.50 minimum Res�mtial, New One &'I�vo-Family 5149.50
Residentiat. Additions dc AMentio� 549.50
The Minnesota Statutes § 326B.]48 .�� S Buitding Pertnif #
"SURCHARGE" has ban changed For one �
Year affaqive PLIJMBING PERMIT FEE � i
Jnlyl .2ol0.untit,lune3o,?AIJ. STATESURCHARGE S. �'�{�,.��.
The mislmu4:aniar=e I'or a"tiud ta" permtt TOTAL PERMIT FEE 8
w � ��+•�aob� 1, sma -
1Lis Appticatbu Beco�aa X'oar Baading PernUt WDen Approved Paid (,� Rec$i No.
. �
, � By
s.iwt.� o�acw n,ce �Q • .
. 24 hoar aotlee ter all fo�pectlom (9S2) d47-9858, taz (� 147-4245
46,46'Daltota Strast S.F., PAor Lake, MLrietott SS972 .
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