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HomeMy WebLinkAboutPlumbing Permit 09. 0266 a>le� ao!ad Alp luawlJedaa suo!padsul pue 8u!pl!n8 'Alaaaau!S 'uoileaadooa noA aoj noA luau •a}ep uo!padsu! anoA alnpagas 0S86- LVV -ZS6 luawlaedaa 2u!plln8 Ileo aseal(' •saaJ l.!uaaad Mau gl!nn 8uole l.!uaaad Mau e aa!nbaa II!M l!Lwad 2u!pl!nq adAl. sm. o1 an!lelaa )laoM Mau Aud •ssaappe sm. aoj paoaaa a!lgnd luaueuaaad auk u! papaoDaa aq II!M }uawuopuege l!waad sigl •(Z•8•SOZH apop 2u!plln8 alei.s aad) •p!Ienu! pue pauopuege 1.!waad waap II!M Alp aga.'alep Aq noA woaj. peluoa ou uaaq seq aaatn •uo!padsu! ue do has o� £ZOZ 'ZZ I!add `Aepuolsl Aq IleD aseald •ssaappe anoge aql aawag aoJ l!iwad uado ue s! aaaw. paaanoDs!p seen ]! 'saI!4 l!waad 2u!pl!nq aq} 4o Ma!naa ul diaq anoA 4sanbaa am •9920 - 60 aagwnN l!uaaad 2u!pl!n8 :ail 6 ,11�d ZLESS eTosauunAl 'a)le� ao!ad VA02 aa��pla�l H±Vd SGIIM L80I7T �� 1 �py3��� o �� S 1 as kto luep!sad luaaanJ 31 �S ETOZ '8 Iladd 'AepuoW \tolva 10; Rro Date Rec'd ..., ' =1'' fl,.e CITY OF PRIOR LAKE PLUMBING PERMIT 41 jn'NESd cP 1. Blue File 2. Gold City PERMIT NOM o 3. Yellow Applicant / (Please type or print and sign at bottom) ADDRESS ZONING (office use) )L0i5 \NJ LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER ( `^ t E K1 5 n A A N J M CS (Phone) 615) — Ob ^' (-140 Q (Address) ) B C IS ' I S , C • • u £ Lk Mt 20D elm I. 1 Ss 22__ APP 8 ENz-g‘ i i1-1\4 "l (Phone) J -) ` �o © o (Na ' C (Address) 2: W b & • *\ I3 B NI 1 LL€ -- 7 �/� (Address) (City) (Zip Code) (Contact Person) Loa 1 PE S " n (Phone) q5"---R:,—)— 1 O o 3 APPLICANT SIGNATURE � . (gill). 6Y DATE 5 - 15 -- 05 APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough -ins Dishwasher J 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 /9,56 STATE SURCHARGE $ .50 TOTAL PERMIT FEE $ , tG . O 0 (Office Use Only) 1 This Application Becomes Your Building Permit When Approved Paid 50 01) c ipt No. 5 13 7 Date 5 ��1 Building Official Date 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372