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HomeMy WebLinkAboutPlumbing Permit 15. 0230 O ❑ n 000000 1) 0 > ■ n 2 nn O ■ -n2 -n -n -n oOC o - n n g 73 z00 1 qg® 2§ I m M §o hi r � X rn ■ r � § § 2 � § 7-I-0 t §© qe P 2§ C ea ea 0 ■ w 0 z 2 § ■ \ a 0 j z -C m m o > > 0 m r o 3 N -' § z 'V -0 m 2 0 0 000000 q x - mm ■ -o ■ m ■ -oo V * § o o | 05 -105 z ? m _ ■ m ■ s 17 n , ■ § k m G 0m ' -11 %.27J7, 2 ?:. § 0 2 § 0 0 X2 § 2 p3 .71 ru / % 2 R m r_ §�. P . o / XI m P tZ o n U 0 k'' -4.- 0000 c ti 5E z G) 21 _ % 0 Q comm9 ® G WI E \ 0 ` »_ 0o2m 'n■ _, Eg k § 0 04 1Rlp� Date Reed CITY OF PRIOR LAKE PLUMBING PERMIT 3 (0 „As 47ivr es t. . aol x. ''zed nk PERMIT NO.�.> 13 cuy 3.Yellow Applicant (Please type or print and sign at bottom) ADDRESS / ZONING(office use) 3C-0 -3 '/(J l /l c B e a c 4 LEGAL DESCRIPTION(office use only) • LOT BLOCK ADDITION Pm &S--. i l0 030 .0 OWNER. f (Name) ( J h r► c r,t e' (Phone)9S d • 3 a(o. to ,/ 7 Ef (Address)C y ( 1 I i / l c w 13 e a c A —7-•-ri , "7 �� APPLICAN (Name) it Pre., 1-1t A 112^ A C (Phone) 9-1J 0 35- 7 7 71 (Address)-2..S-t GOiu 3'G J Edfh pre) /14// S3 (A es)/ (City) (Zip Code) (Contact Person) 10,l H 4) (Phone) 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 FTile Minnesota Statutes§32613.148 ...,_ oli cost with a$49.50 minimum Residential,New One&Two Two-Family $149.5 "SURCHARGE"has been extended I3 Y Residential,Additions&Alterations 49.50 The minimum surcharge for a "fixed fee"permit is$5.00 • $ Building Permit# -PLUMBING PERMIT FEE $ • STATE SURCHARGE $ XXX 5.00 TOTAL PERMIT FEE $ (Office Use Only) This Application Becomes Your Building Permit When Approved Paid z5-/, 9) Receipt No. gi-3 Buildinn Official - Date Date 3,Ig `5 By fa/4__ 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372