HomeMy WebLinkAboutPlumbing Permit 10. 0339 0 LIZ
J I... Z k.
'17 2 O .a
w au.a O Q
- \ LL Z0 U uj z Z F-.
� ggg ] a cc
ui N
Li,
1 M F 1UU.u-O 1 ul = 0 \ 'Z
.- U" 00 000 1] ' 4 O cc N: Z
� +° W Z a C.
O r-i - , i Z
0 � W ti
o
`\ ,1/ r : '::)>„ y
:_d W 1 z a O a F',..
x
I� u. Z 1 Z X
0 . ► z = x z z w w a 1
z— u
0
a = W a = 0 0 o z
co 2 aw a �W a a `� ►-
l. n"'Te�.N Q. a � a W
V` Q
ce
l a �- �,
W u1 , a V U J A
N W
O 0 O a Z a 0 a 0
it C4 0 0 t v O
p Z (7Q N W U U N
a 0 N Z z z Q 0 0 c
I- '� s � �� aw
u. 0 W W z 0 O OG i N .0
O a 0 LL u. u O
a.
0
v?
4 1 OOOOpa 0
C Date Recd
(.i .--2
� rRiO� CITY OF PRIOR LAKE PLUMBING PERMIT
INNESpiP I_ Blue File �, V Geld City PERMIT NO . . 337 s /
3 .
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS , ZONING (office use)
c S r i nj L-M- ocLt
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION David Auringer
3019 Spring Lake Road Sw
Prior Lake, MN 55372
OWNER D6Lt/r L I f f j�4 9522405627 (Name) ( w J
(Address) �5� 1 cl $9fl �J i_m i`` ci `
APPLICANT
(Name) (Phone)
NORBLUM PLUMBING CO.
(Address) (61, 2) 827 4033 (City) (Zip Code)
29 ciARFIELD AVE. SO.
(Contact Person) ► 1 ► ► _ . A _ 0 a - ,g; (Phone)
APPLICANT SIGNATURE �
DATE WI 0
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough -ins
Dishwasher i 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 $ a Building Permit #
PLUMBING PERMIT FEE $ 4 01- -
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $ t >o'
50- --
(Office Use Only) 1
This Application Becomes Your Building Permit When Approved Paid U Rec i t No( 0 I q c
Date�� (. I d By -
Buildine Official Date J
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
1
.Z1'.'A CJ3IR5L , .
Vft' r+, p
CONT,3