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HomeMy WebLinkAboutPlumbing Permit 14.0037 1 5 0 01 0 000000 0> En r, n k © 00 E 0 �kkk Z m � c o m m n % r R 22 E &r� § § § � � ii l t : , ) 0 § -I § z 0 / 0 & I Ti " 0 \ ~§ _n - o n Z n k 0 � � z 0 m ■ r 0 • 2 - 0 'a • m 2 0 0 . *0000 ` �� m m fll �r � ■ o o o z PI' - 2 c I. ■ Q ' ` m q § m 0 0 R z ~ n r � k0 23 k p q _ } 2 2 cc r 0 ' CO r Z r / z x 0 E. m ] 0 . . 000000 y E z $ 'ten§ 0 carnIng© : / a ri sss 4 m 73 -n 2 FA a z m - I r 0 V , Rt® Date Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT I. Gold File P ERMIT NO. r L� z. cola city � 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING (office use) 3 Q W (� G(i�✓ Wit; fir" LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID ((Name ' J 0 (Phone)95D) lqac (Address) AN`QJ ?c\ D( UrR, APPLICANT (Name)_ l OV") P`�/l�p Y� c (Phone) (Address) VQ O y ' 5 �3 (Address) (City) (Zip Code) (Contact Person) C‘S (Phone) c\ ) ' `°-'- O APPLICANT SIGNATURE DATE 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 $ Building Permit # PLUMBING PERMIT FEE $ -SO STATE SURCHARGE $ _ U '0 TOTAL PERMIT FEE $ 04— 50 (Office Use Only) This Application Becomes Your Building Permit When Approved Paid rn R ipt No. 105 Dates , ituI►dfns Official Date � l 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 � - �,,�,. ..�,�'" ice' �.. w � • 'r te `.. <,...�;+�s�'t .::...�....a- ass -, .�, « ' ,`00% " :�ex<. , .�m� -.: �% Pt - s+ - ep