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HomeMy WebLinkAboutPlumbing Permit 09.0354 p D o 21 x < < ' ‘ 1, , m „, c o m - m b b tri r- r m m © (TI �gaz O 0 * t - { -a > 'c i z m O O O O 1p V G D 0 2° , (p n z Z • m O - 0 m 0 O c 0 h 0 n DT. m �.V n 0 \ _ —. m m r v z O 0 �` 00000 0 o x z m m _ ` mr *3 ( r / Xi cn D m 1 [` z 3 mi 3 - 0 cn g O 2' m G -rW23 73 z M 0 0 ( � C .. . zzmx 0 3 z m V ,v 0 n O r- -n 0 0 73 11 P C O P m ^ -`� \ D v v O m O z -n r O = m O ti m 0000❑ 11 o z 0 b71730 - - r C m A' v O r1-0v� W Col < '1 A ' DD ca 0 Dmmzo Vj (/) f \, ir 0 PRt C .)/ 1 C CITY OF PRIOR LAKE PLUMBING PERMIT Date Recd 6.(0.0 iitikivEsoo I. 131 r d File PERMIT NO. 44 2. Yel Cit O G O�� 3. Yellow Applicant I . (Please type or print and sign at bottom) ADDRESS ZONING (office use) , 17116 6-to briar C- E.S.LO, - Pri o r Lake, LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION . PID OWNER (Name) k .t.. t l je,, ,, � a SC ti tct� �J (Phone) 95 2- 2-2_6 & 03 4 1- (Address) s� ) 17 I ( S-bo he,b r i air C`-1=. S. W. yr, O , Lake, M 0 APPLICANT - (Name) D ra t k O `t-' u r.49 [ 4 G (Phone) l'"2 46 q 6 e l t q (Address) e) E5 1 5 2D el - 6 5t La Le . i/ 6 He 550 4- L- (Address) (City) (Zip Code) (Contact Person) D eb or 14 V 't S� (Phone) `, 2IV6 C1 & e l e t q t r AlAPPLICANT SIGNATU / ' r all 6 DATE (0 ' S .0 e l APPLICA PLEASE SL 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 (I or 2 compartment sink Sewage Ejector Shower Stall _ Backflow Assembly Sinks Backflow Assembly Test Bar Sink 1 Lawn Sprinkler F V 3 1 i Water Closet (Toilet) f Other i FEE SCHEDULE Industrial, Commercial & Multi - family 1% of job cost with a $49.50 minimum Residential, New One & Two - Fancily $149.50 Residential, Additions & Alterations $49.50 Estimated Cost $ 75. 00 Building Permit # PLUMBING PERMIT FEE $ `L"t . 0 0 STATE SURCHARGE $ .50 TOTAL PERMIT FEE $ T5O 00 (Office Use Only) This Application Becomes Your Building Permit When Approved Paid ell n ) eipt No. �J�. 7 z._ r/ Building Official Date Dat (J' 6 r /UG • 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E,, Prior Lake, Minnesota 55372