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HomeMy WebLinkAboutPlumbing Permit 10. 0187 tu z / j � w w d 0 \ Qo ® 0 )7)c \ o \ 't V � On _ r< z z V. —mo ��o E2 m Jh D0000 > § �� . 0 E \ o 4r- p a s 1 w { 0 k 2 2 2■ Ni 0 0 k 0 Q E 0 oo w w z ce 7 ?§7 0 c a G S 0 a �$w�B m j 2/ j /� § ]W w w § 2 • a ■ Q • Q il 2 O OOeoo 0 U / / . a a \ k \ ~ 0 CC w \ / z \ z 0 \ ? re z o z w < 3 a 2 0 < $ 2 k w w j\ U. w W 0 \ \ \ § © � � re z oo @E § 0 K o UU.U?cc ■ Q . > 0 0 5 ? « 0 a 000000 0 b 0 0 _ 04 PR,94 Date Rec'd t � CITY OF PRIOR LAKE PLUMBING PERMIT , to L I �x 1� NESn�� I. Blue File PERMIT NO . 2. Yel Airy f 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS _ ZONING (office use) 171 ?( &uiset Jra I 3A J LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER e U S/ J e (Phone) 15� - ki L T3 (Name) Pr / / � / � Phone \9I�7Y) -QJ r 1. , ° ` N - 5537 7 APPLICANT (Name) Champion Pii_1mbl'l (Phone) # 61770-PM (Address) 651-365-1340 ( cp as Ka., (City) (Zip Code) Eag , iVIN 5512'3 (Contact Person) )' I.S (Phone) APPLICANT SIGNATURE , .# _ DATE 2- 0 A 'PLICANT 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 $ q9- - so STATE SURCHARGE $ .50 TOTAL PERMIT FEE $ (5) ' 00 (Office Use Only) 1 This Application Becomes Your Building Permit When Approved Paid 5 - 6 c , , Receip o. �, --G O �� Buildin Official Date Date- � • i 6 By D • 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 ` , —7