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HomeMy WebLinkAboutPlumbing Permit 14. 1062 F. I �os Li.5 yr2a 5_ UU : z ri X555 =4 >,o PI �� OORW' 5N z `c rUu.a �� W z 6, ^- � ❑ ❑❑ ❑ 01 > co a m re N eX � O 03 J 0 NC Z _ > > Z p 4 0 F m pptiJ O 0 U Z Z ce Z - == Z= W a I f0A 0 OW. mSWmm = 4.4 a 0 Z . a23toaILI a , W W W W 000000 UhJ :J1 reWVY • ~O Z fnRZ Q Z W O�'Io Wma° = Z< N o. h w OW m W Z OOOC?gt 2 Qg O 0 a V Va 0 E O au. u.? tiW S U U1. ? < o . 000000 CC) 0 ❑ 5 PRI0 CI Date Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT q`. 2- 9` 0,soo ted Yellow (Please type or print and sign at bottom) ADDRESS ZONING(office use) glob Gnes'-hint- La N LEGAL DESCRIPTION' 0i/ (office use only) //� LOT 1 BLOCK I ADDITION e/Q ore, /1. �5 j /1dd PIR5- 3o 0 ' I- 10 OWNER Ramk P'et,141 soh (Phone) -!J2 l C 3901 (Address)1.2-04e) °ICS-1—n 1 Lek N APPLICANT Appliance Connections Inc. (Name) 12850 Chestnut Blvd. (Phone) (Address) Shakopee, MN 55379 (Akikas445-4803€.ii 11 (City) (Zip Code) 1'C.t (Contact Person) I tC ' ) (Phone) APPLICANT SIGNATURE ,u o ) DATE V'1 tt !PPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough-ins Dishwasher f 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 $ Yuv./ Building Permit# PLUMBING PERMIT FEE $ STATE SURCHARGE TOTAL PERMIT FEE $ I. 51) (Office Use Only) , J') This Application Becomes Your Building Permit When Approved 'd 1I SD Receipt No. /2 /t By `� Bafldine Official Date I21 (24 hour notice for all inspections(952)447-9850,fax(9552)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372