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HomeMy WebLinkAboutPlumbing Permit #12-0726 S ❑❑� n ❑O❑O�� � O D Zn N n � o 0 0 3 N ���o� z � °� m� r� � g „ � � � m m y m y Z � t '�� �t'+ �, -�1 - > Z � � � -�1 '� � z � C A �� y N "� Z Z ��r ~ � Z nD O � � a � "+ m z � � v � �o v � P� n � ❑�OOO� m m m ��rn�;� o z v o m��>mc �• � �' ` i���i� m n v, � c � Z� � � m � � = r�SS �o = � ° �"s i � m � � ' � � v � � ° � � � � N � y m OOODOO , � � Z z ���o� � A• o � C���v� � n >mm�� � m ��8 F � —�'i � c=i � rRrp Date Rec'd °�-� � �� CITY OF PRIOR LAI� PLUMBING PERNIIT �� �� � �� �� �f�'NESQ� �. B��r File pERMIT NO. z. coia cny — � � , , 3. Yello+v Applxanl Please e or rint and si at bottom ADDRESS ZONING cotrre �� � �J O � LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID � OWNER . (Namej l i ��+ _ �M. �,('4 �A 411 (Phone) ��a' � � --� 7� _ (Aciaaress} ��? { y f 1 i S 'M 1� cj ��-IC� APPLICANT . (Name) M � �— 'C'.��_ l �._ �� � • {Phone) 2 (��J � �� — � C� � 7 (Address) � I C�3 � s��n-(� o S'r 1� � -� �'N�— � 1� C J�y �'��l - (Address) (City) (Zip Code) (Contact Person) � � ��Q..�� (Phone) � �O � � �� ' �1' � � __ APPLICANT SIGNATURE �/�"`-' DATE �� c'� l I� APPLICANT PLEASE COMPLETE BELOW Quanti T e of Fixture uantit T e of Fixture Bath Tub with or without shower Rou h-ins Dishwasher Water Heater � Floor Drain Water 5oftener Lavato athroom Sink Stand Pi e ashin Machine Laun Tra 1 or 2 com artment sink Sewa e E'ector Shower Stall Bac�low Assembl Sinks Back£low AssembI Test Bar Sink Lawn S .rinkler Wate: Cioset Toitet) Other . FEE SC�IEDULE Industrial, Commercial & Multi-fanuly 1% of job cost with a$49.SQ minimum Residential, New One & Two-Family $149.5� ' Residentiat, Additions & Alterations $49.50 The Minrtesota Statutes § 32G.Q.148 �� $ �O . D(7 $uilding Permit # "SURC.HARGi;" h�.5 been chan�ed fi�r one � year effective PLLTMBING PERMIT FEE $_ .i►31,v I.'1010, i�ntii .➢une 30 20� t. �` STATE SURCHARGE $ ` .5{� `" The miaimum surchsrge for a "tixed fee" ���•,,,;c . TOTAL PERMIT FEE $ ��� � is�, be�innirtg.luly l,?Ol = This A Secomes Your Building P rni When Approved Paid t �J) Receipt No. � �� �7 -/ J '• y Date ) By ' Build' � t Date �/l IY � 24 hour notice for all inspections (952) 4A7-9850, fax (952) 447-42A5 4646 Dakota Street S.E., Prior Lake,l4linnesota 55372 ;r � , , ��� �� � �� �� . �� : � � ""'"� � n� �� � �� � � �a � .:� � Z z m � _ ( � (� � 1Yl � �° � � �z � ❑ z � �� -�, . . N v, i : ( y�' O i � � . � .�.. ➢ C � � _ n w � � z Q � o � � � � � � • .. • � .I � A ti C • ' " ' ' . 1 �'� . : � J�� . � . . . . . . . . . . . y . . . . .. . V .� � . � . � . . . . . . . � . . . � . � . . � � ' . . . . . . . . . � H , �.�_ . � �� A Y �^� �" � 'L'� � � ; � . � . . T1 '�i 0� � z P 2 N � W � , � � ° �� :_ .c = . � f� � CJS � � � b ° e _ X O ' . � -o « n � � . . G � � .� , � � � w = — � � � � � . ,� � . � � . O G � � . � . . . . � � � � - . � � � : . � �' ` � �,."� z. �, o � � . � t � � m � � � � j _.��f.� o °N � � � � .� -� � � ° � � , N :�,� , �,� -� � g � ro � �, , � r .,, �- � ,� U : b . _ r . � 0 . . .. . _. �. _ . . _ J � . � � - . ., � � . . � . . � � . � . � � - . . I hearby cerlify this plan was prepaired by me Project: orundermydirectsupervision Mid-C1tyMehaIIiCalCOrp Holiday Stationstore #198 � Registered Master Plumberwith the State of 9103 DavenpOrt Street Ne. �� Minnesota. LicenseNo. 058380PM Blaln2 Minnesota 55449 16800 Duluth Ave. Se - Prior Lake, Mn signed: 763J86.8617ph. / 763J86.8640 fx James Poser ! ��y�t � � Ir � � � � �� . � � �� � � �- � � � � � ..�. �.�. � � �, �ir �� � S, � . 4� � • � ; -�1 � � � �, ', � � _ �� �. ,. � � �