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HomeMy WebLinkAboutPlumbing Permit 10. 0070 5 0 0® q 000000 1 0> E ® 0 ■ n —nnn 0 $ § $ q 2 0 xi 73 k s A § @ ni @ % r 0 o ( m $ \ E2■ g . co §-0 % q q Z �Q� • Zk co i § / . 0 0 \ 0 �� \ m Fri » r § 1 k . % % rn 2 ° 0 000 000 X q 2 m k Z '0 ■ Z "0 § © © 0 C -4 0 2 m !i i . -a§§§$§ m§ 0 0 § No m a q z§§ § NI Z v\ m § J 0 - r 23 q 0 0 c ....4 2$ � 1 1, 11 z m 0 c.,,,,,, 2 ■ -n . . • . • rn X 0 k.... CI < 00000 , ` m Q ■ 7 t» ). P g m . m A. < ® r§rlE < ell D ~ � �� \ of 4 in k -4 0 i C 1Z C/ Date Rec'd NESO CI TY OF PRIOR LAKE PLUMBING PERMIT Z .. i O P 1. Blue File 2. Gold PERMIT NO . Yellow Applicant ///// 7 ,,, llp /� 3 ,..., . Ye t (Please type or print and sign at bottom) ADDRESS ZONING (office use) 141 gmewood Q. HE LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID (Name) C{ ht rW r(i (Phone) 95A-4-33- - J 1 (Address) `J � (y j tJ '•t or Lx(;kci , 6/ (\ - 5 53 APPLICANT (1 , (Name) ( 47i fl j 10 0 ?/U.f Yl,y (Phone) f '- 5" 010 (Address) / � /. ∎ A ■ .. �� >� 55f . 3 (Address) (Ci (Zip Code) (Contact Person) 1-..) (Phone) (XYl-Q.? APPLICANT SIGNATURE .7` ' -"e DATE .2.—_ (0 APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough -ins Dishwasher t 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 vl , STATE SURCHARGE $ .50 TOTAL PERMIT FEE $e) . 00 (Office Use Only) This Application Becomes Your Building Permit When Approved Paid 5- Re. - , No. 3 7,, Building Official Date Datez. /d'`U 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 O ' I/ 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 ��