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HomeMy WebLinkAboutPlumbing Permit 14. 0797 i \ 22cc 4- 0 � � � id < % © 55511 > k 0aaaQ $ 0 2 ert_ dO � � � ' ❑ OOOO� ' 2 cncc 0% - C 0 re 44 0 Ei d a. n. r ■la k § 3 2 � � J ■ 0 0 0 . E E " ir. X B & 2 XXZA ° CZ § 0) 0 a fa 16 Ce I a. 0 k a. 2S § a. 2 \ wrtww w 000000 0 0 § a wa. 0 o dr rt 0 < a LU uj 5 P 0 0 0 N 8@ e ■ U 0 a Ez 2 �0k 35 z I ILI 2w §§ U.2FI ■ 0 � 0 g LI 03 < 0 a 000000 S \k„ 00 Cl 4 P p� Date Recd CITY OF PRIOR LAKE PLUMBING PERMIT -. lg z c5, PERMIT NO. 3.Yearn, Applicant ��` (Please type or print and sign at bottom) ADDRESS ZONING(office use) 41°C161 04 kWo< C CC(e .51 E, k1 LEGAL DESCRIPTION(office use only) % �j /� LOT BLOCK ADDITIONel/ �i J 07 / • Ats6 AY PID Y 'c RO ' O2 `0 OWNE (Name) Pa.h G-0 Me 1 (Name) p (Phone) �[S oZ',�aoZ�'1�.S�D� (Address) l C Oct k wood C i 'cc-le- S. E. 2 P r16 r L-4<<'� r N 5✓�3?�-- APPLICANT i (35c)-- Q car (Name) ri YNR 5 U a % y fi ul Y`^b+ r..5 (Phone) !5 ^ p c7S 3 L-{".3 (Address) 9 R.5 C o u r J-y R()Rol ,3 I O ,e U V 5S 30 -� (Address) / ` ` t (City) (Zip Code) (Contact Person) I 1--YY\ Li 1\� 1 .C) 1 I (Phone) ]?flY\e— APPLICANT SIGNATURE A I • r. /% / * DATE _____g_4I PLI'ANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough-ins Dishwasher i _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§3268.148 lot cost with $49.50 minFEE imum Residential, Residential,New One&Two-Family $149.50 "SURCHARGE"has been extended Residential,Additions&Alterations $49.50 The nllnimum surcharge for a "fixed fee"permit is$5.40 $ Building Permit# -PLUMBING PERMIT FEE $ L[ 9.15Q STATE SURCHARGE $ =I 5.00 TOTAL PERMIT FEE $ 5 t.5 O (Office Use Only) This Application Becomes Your Building Permit When Approved Pai?k `LI �� Receipt No. �f DateBy Se. --------- Building Official Date . l L 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372