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Plumbing Permit 13. 0377
— O 0 A 000000 I o> /g ' 0 0 0 0 §] K m 33 0 m 0 -o k \\ 2 m m z �� � kj z k -� r RI § t \ m co - w . 4 P Z - & w 0 m cn g z 2 § x § r ~ pc ._,° \ 0 °° B\ o w mm \ 0 li / } : 4 -4 xi -n 13 _. m 200 © . 000000 > } - m § q��t�� c c ) \ \ / CO ! % § Xi 73 { § m o 0 2 21 6 0 � >000 0 k ni \ 0 z — z \ c PC k k § m r-i P m C'.) V 0 ,, 0 m \ § § 'OOOOO vt c o 2 2 ?II§§ ®A 0 U)mm ■0 0 o � � k � � � K � 7 � /f > ��,3 r q � -- / k ( ( r 0 5 ❑ II 46 C) 000000 = 0 D 20 m 0 0 0 0 t "y - N'_- iz 0 m m 0 p O 77 X 73 I ' mrc z0 m xi m n 7 lb X m M z �zoZ Z V) � ›J r � - --I D Z 13 o — - ,, O O Z-- ir , m m Z i T ro ro r" o O •� 0❑ ❑❑ ❑0 Z m m • f n �► Z zSx - z Z G S it, b 0 n o ' y t r T 0 0 21 3 al P 0 o o Z Zcc Z r un Z y m rroro O m y ta \ 1 � �` N ;"� T m m C ( • X00000 N o D Z f �� Cn m m 36)) j R m y Z Z m -4 r O , ) 4 PR/04. Date Rec'd .4 e CITY OF PRIOR LAKE PLUMBING PERMIT /� v 4 g .'NEsoo . Biagi Yell F p ) PERMIT NO. 1 3 p/ 7 I 3. Yellow Applicant c/ (Please type or print and sign at bottom) ADDRESS ZONING (office use) 3 q 4 (c \i'l\,/,(../ -- OA C.4•Rj ,5 \i\,16)11A 0 j_ LEGAL DESCRIPTION (office use only) {� f `� LOT BLOCK ADDITION 0 W ` PID OWNER (Name) (Phone) (Address) APPLIC {� (Name) N, )Yi s �"' ) 4 Lk / (Phone) 1 6_5 5 - 2:2L (Address) 1`�'53`7 I L l..fL. 441 PI L ✓ nkci - -i'1 5`_ 41 (A dress) (Ci b'i y) (Zip Code) (Contact Person) OM� (Phone) 23 1}7 APPLICANT SIGNATURE OLt - 6,1,4A.HIR DATE 6 " 2-6 t 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) /A/67711J - Other— 1AALLt,1r(L"-) u- 22 p nit.4 4V6. FEE SCHEDULE 3 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 $ STATE SURCHARGE $ .50 TOTAL PERMIT FEE $ 5 4.1- U (Office Use Only) This Appli`, i /i eco't es Your Building Permit Whe,n Apiroved Y454.s-0 Receipt No. t . ►' ___ 5724/73 Date �P [ By cA _ i ui dine Official �"�- Date ` T 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 �AfiIlfAMn....,, ,