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HomeMy WebLinkAboutPlumbing 14.0092 5 O0 lg 0 000000 0 > z0 n k k kk � �� 0 0 � § r q P) ■ x s r Ez§ ■§ -i@ § t \\ 2 0 - P � 0 ® $ » ■ © Z 0 Z S �. j k m - z 0 m m t 0 � ���• z § ; - ! r 0 2 / § z 1 0 0 0000 0 0 41 X . i�mq �r� ■ 0 CP - 'z o o n c I nc § 0 , § 0' 0 (\ r-n§§ z§ ru 0 q - 0 Z r ■�� z r NI 0 2 K � m . . r 11 P 0 / X 73 0 C m ■ 2 n ?1,9 2 R . \ XDOOOO m _ o Rs > ����§ > ® ^\ E� '0 �z .. M> Pgi 4m N hi ' l l 0Z § r -I 2 2��r ■ -1 r 0 rk. k ,o4, PR /0 Date Rec'd ,' �% CITY OF.PRIOR LAKE PLUMBING PERMIT j NES 'S' r t 3 t 1. Glue City PERMIT NO. / ¢ ya 2. ? Go City 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING (office use) I_ i % :!k)6 /7:4 l -fti / 4 9/,,.' S f y . ; ,,, -/ k'.A LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER , 4.-- ( ) 1 � (. --d v ' ; f -0 , (Phone) z7' 9 7 - . - " � Name f �'�` � .� r�` �. i� r'.. (Address) /7.) (.) t. t /it/ i'--4...-1. '":- ; ` 7 ,', e -'� -c 17). ,t. .ci7 -_, . -) APPLICANT ✓ (Name) re m,. t r ru i r 1 (Phone) HEATING &AfFI i Wil)IilOhllNG INC. (Address) (ashington Avenue (City) (Zip Code) Eden Prairie, MN 55344 (Contact Person) , . 52- • 4-1 ' .--- 2 t _(Ehgne) '' APPLICANT SIGNATURE PATE , . y f _ 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 S Lc C. D ) . t t 4 ... 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 $ 7 9 cc STATE SURCHARGE $ j e "c - .50 - TOTAL PERMIT FEE $ 5 y , ;) (Office Use Only) This App anion . ecom ' ing Per t Wh n Approved Paid Receipt No. Date 2 �' / 4,_ By it Building O - icial Dat . 24 hour notice for all inspections (952) 447-9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372