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HomeMy WebLinkAboutPlumbing Permit 10. 1062 5 0 0- 0 000000 • 0> Es n A n k o o 0 . 0 g /Bk ° z§ / k r k k/ m 2 � \kk k z m �-a ƒ t g > k -1 m 0 � � � � 0 K n ,. d 0 § ~ M \ z ■ 0 > > ■ ■ r 0 3 H 0 H © liii 41 x q m m mNs ri CZ -4 i o o• nc § .40c 9 Xt % : ma mm I 0 ■ k ƒ \ � � / B Q § �K § z s % 0 0 0 r -n §o 73 -I . • a c ) M % S z , z c� z r c) 0 R m 'I r a 2 k 0 ' \ § � j II �� • . � 00000yPf ■ ■ Rs > 0 �� i kk i § � . ~ > CC C'' M K ^ '>mmF 4 �� § k -4 § 0 o VRIo Date Rec'd N CITY OF PRIOR LAKE PLUMBING PERMIT x M 1 INNES0 1. Gol d C ie 2. PERMIT NO Gold City / a / 0 & Z 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING (office use) I G9 g 1 Pcfl OY- LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID (Name) WNER � ctukur____ I (Phone) �1C (l� "l I r C� 1 (Address) `1& t 1.1(. -U N \ S APPLICANT I q531. � � (Name) e �C / `'�A . LA i (Phone) - . .. (Address) '"_1,' VW 1 ../ f . - klq- C.. '/I � ((�(A� Q re (City) �j `'� ' ( (Contact Person) i�kl LAC AVAR ` (Phone) I -�(J�� ' J APPLICANT SIGNATURE . R '. � , � . _ A � ►iP DATE I 1 t 1 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 $ 'ibU Building Permit # PLUMBING PERMIT FEE $ STATE SURCHARGE $ ! . i TOTAL PERMIT FEE $ -5-1) (Office Use Only) This Application Becomes Your Building Permit When Approved Paid 5 .-- so Rec No. 40 ?�.2 Date /. -. 7 / � Building Official Date (' r • 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372