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HomeMy WebLinkAboutPlumbing Permit 13. 1067 R 1 J la z Z�\ LLZwwa 0 w 0 0 Z C - w Q h N, I � Z Z W 0U. w 1V U O w = re � \ ■ O N w O an J m c Z Ci H 2 o o — , ' , O 0 0 g cC w 1 g O o o0a \ U c w j 0 d m = W a n t , a 8 Z O z \> ? WQ = ,, ` 0 W co x u. a 2 S cn a 2 \ \ w w , w 1:13 0000❑❑ \ O o a W 0. U. a Oa. O H ce Z ■ 0 W 0 `_ LI- a z z ° a 3 a Z O w ~ t- f- \ W C4 co O zaz 'n Z LLI 0 w w \` w re re 0 W a W F-z — z'� aw 2 a ° o O a w oo� Z ° '�z~ } 0 } 0 0 ai 0 a 0 Z 0 LLLLtL.? 0 0 d U? a O a y 0000❑❑ 0 o c \ o -J ®\ _1� § N. j �wwwok W § RA \ ,1 k \ \ > • \ ` 02wi0\ o > q w 0 c re Ce = o % 2 z b ( OOCO2K| ¥ CO � 0 o • L44 \ 0 • ) K , ° C \ § & z a. a. z L.: 0 § o E g o ou _j % N 0 0 0 % } z ce z_xIz O k a- 2 o% o w amrtWaI \ . ( f 2 2 0w n 0 } �§ m �� ` w w M § 000000 0 o § w . \ u I >: Z �� 0 § ® 0 < ' ) i. p z 0 0 ` \ 2 § ƒ P P © @ 0 z 0 0§ „s• / k / a Z a 2 « 0 0 . % g cn 0 z < z 2 ® w § .. ® - SG w ce o -. ® o D n § 0 0 2 § 0w �u w ■ w 0 � ) m4 A re z oo ®� o § 0- 0 �uu Q « 0 0 Q. 6 ? 0 0 1 000000 0 0 0 / ./ 4 ?RI Date Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT v a '' NESOc I. Blue File PERMIT NO. 2. Gold City /mi 7 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING (office use) 3 (o) faii 1/14ln 7) LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER � n / (Name) (Phone) (Address) APPLICANT (Name) 0 (Phone) 6 �2 (Address) V2- U. 4 ri 11A/ O, STY)/ (Address) (City) /,. (Zip Code) (Contact Person) k� b S (Phone) a') APPLICANT SIGNATURE DATE 9 , ?- 5--7 -3 APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough -ins y 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 The Minnesota Statutes § 326B.148 FEE SCHEDULE "SURCHARGE" has been extended )f job cost with a $49.50 minimum Residential, New One & Two - Family $149.50 The minimum surcharge for a Residential, Additions & Alterations $49.50 "fixed fee" permit is $5.00 $ Building Permit # PLUMBING PERMIT FEE $ STATE SURCHARGE $ .50 TOTAL PERMIT FEE $ C" / r7� (Office Use Only) This Application Becomes Your Building Permit When Approved Paid, J Receipt No. 70d l Building Official Date Date 7// By ("14_ 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372