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HomeMy WebLinkAboutPlumbing Permit 09. 0147 - 0 O§ n 00000E ti 0> -n ra % D ® 0 0 0 0 g 3K V§k Z m m 73 k §0 / § / X 2 7\ g z r � ® § d z $ -4 -u * § \ z $ \ P �k 2 t 0 0 .-..1 o z z 0 29 2 k © q ` 0 0 r, on z n� o z w _ , m m \ 0 � : z 7 1 1111 ` - q m � � f 200 kr' 0000=0 > q - mq m t " t §-a % z i /oo s \ § % k m O } k \ m § - 1 >000 0 k m $ U 0 zm 7 z - § $ $ 7 r- §§ p § it " \ k o I m , � 4 ( m � —0 ;1 / < \OOOOO § /] §§ q § < 0 �� /k % § �k §%§ q m ' \ �� § k 4 r § O� rr P R Ip� Date Recd t CITY OF PRIOR LAKE PLUMBING PERMIT i'NESO 1. God File PERMIT NO. 2. Cold city / 4.7 (Please type or print and sign at bottom) 3. Yellow Applicant ADDRESS ZONING (office use) 72 32 D - i c _ LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER ,—� (Name) 1`) 1 Gv) K V CV) Off (Phone) 2 - 4 P V7 1 (Address) /72 3 -�/� 7� / r � r � il'7r thke %7Ji �� Y /0110/i c ipf�ri P /C //� -' ,b�n i one D /2 7+0 1 3L - 5 J (Address) �� ��-)' 2.0(i2 L' ,[3 (J ]/r S, /) 11(. KAN1 55a - 7 2 (Address) /,, (City) (Zip Code) V�(� G[ (Contact Person)BV YJS,Orl (Phone) Co tI APPLICANT SIGNATURE DATE APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough -ins Dishwasher Water Heater Floor Drain Water Softener Lavatory (Bathroom Sink) Stand Pipe (Washing Machine) Laundry Tray (1 or 2 compartment sink Sewage Ejector Shower Stall Backflow Assembly Sinks Backflow Assembly Test Bar Sink Lawn Sprinkler Water Closet (Toilet) Other 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 $ 4 , STATE SURCHARGE $ .50 TOTAL PERMIT FEE $ . — (Office Use Only) This Application Becomes Your Building Permit When Approved Paid Recei t No. vim, 5 - 77Z Building Official Date Date l 6 O� B 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372