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HomeMy WebLinkAboutPlumbing Permit 10. 0414 5 0 0 0 00 000 0 - o 0 > ZC) 0 0 O U )TI=TTT O - O O 0 --12N C Z m X mO CI • 1 - ° A X 7J xi X 7 E v Z O Z N - � = D Do -1 1 -1 D Z -p -1 O -1 L7 Z - t 0 D N w 0 Z z Z • co x ".1 D -. O k O c - O - - i z m x m r v Cl S T • m X O O ❑❑❑❑❑❑ .11 m m m m 3 - 0U► *3v O -4 2 m p 0 w nC �n N 3 m 3 -o 0 (' N i O N 2 _ m �_ T W 73 XI �p� m 0 — 0 o m >0000 0 3 - R 0 ., m n O r TOO xl =I 0 to o y cc c" m • K3 1 A O 1 = m t' �U L ti m t1. ❑ ❑ ❑ ❑ ❑.,C (n °�? / > z 2 `'/'' > z11 O ^ C• p� > D Nmm3G) / m R. O � , m Z l) C)Z -n N 2 — z m -1 i D - 0 C/ c . PRIp Date Rec'd i iik N CITY OF PRIOR LAKE PLUMBING PERMIT ,_5: ZET /v v 41 t�'NES O 2 1. Gold City PERMIT NO . �J . Ye pp /1' / //� 3. Yellow Applicant !/ V T (Please type or print and sign at bottom) ADDRESS Q ZONING (office use) 32_55 B,4t n ` '. 5', 0 • LEGAL DESCRIPTION (office use only) i LOT) BLOCK vo I ADDITION - 1 r✓1 fY1 E f iAA N -S PID Z540 7©© )0 OWNS r (Name) fl- f (Phone) 'S,Z - . (Address)AX :16 8.4, 5A n e ar, 5, k). APPLIC T (Name) , Z nn in, ttrri;a (Phone) q 02- 441 - 5E >k4 (Address) 32,3, U ALS.A;KI —r 5, ■-0. . i;11 -)L ,'l4— Md . 5 63 7 (Address) (City) (Zip Code) f � (Contact Person) 1� . Q) "1 net -) (Phone) 9 9,2 • 440 6 APPLICANT SIGNATU' % '- ��,,.-` , i . - DATE b 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 $ 1 5 STATE SURCHARGE $ .50 TOTAL PERMIT FEE $ .57). OD (Office Use Only) This Application Becomes Your Building Permit When Approved Paid .5 -- 03 ' ipt No. G 03 7 7 Date - 21. ( v i • 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