Loading...
HomeMy WebLinkAboutPlumbing Permit 14. 1100 0 0 `AINn 000000 T 0 > zg ■O � � § § �4n n J § R E2> c§ mm co m0r z xi x cm@\ % r �\ CO* % � �kk /� 01 10 » ] - z - 0 0 L Ch 0 Z 2 z q � § k % \ / mm r z 0 72 7 4. a ti e4\■ z 73 R 0 ' 000000 O _\ § 0 0 - mr- ■ 7. ■ r i ■ ■ nc2 _ioc 7 ▪ k ? -o ■ ■ m x s 13 n ■ 2 I) = 0 21 § ■■ ■ § m 0 n m gi I § Z§ § XI x NI o z r � §o xi g p v . . 0 /k-o P m / k § 9 z c c q / �_ 2 G gOCOoo Z m § > is > © O /kk0o c) ,--t- 131 \ Z k;; ;SI -13 II§ _ NI 0 » R � ■ m % mom ■ " F d f V z ■ � § @ ? I (1- 1 2,-/ S-- 4 Sci.s0 - cl..., EC> QPRIpDate Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT •. //), 6, / v N,NEs F`� PERMIT NO. I/t;71- -- - . 2 Yell Applicant `l r �r^r (Pleasetype orprint and sign3.Yellow appticane /�J. t at bottom) ADDRESS511�� ZONING(office use) , Oa Kay Cck �� �1 s� LEGAL DESCRIPTION(office use only) _ 2/ 1 • LO 7 °AI< A ( ` /1' '� LOCK ADDITION" � �L'��-� �� PID � C��3 ` r�,� OWNER _' / (Name) mot �d. .LJI A (Phone) 9 2 - -I t} I/?(o& (Address) 152.V 7 Oa.k gi AY. C i r c. APPLICANT ts' S 2 LiTI 0U V(Name) CZ—_ g CLL__ (Phone) (Address) 22,"0 _ LA3 �i lb (3 .n S V( ( I C SSS :i_ (Address) / (City) (Zip Code) (Contact Person) A v l lel.. /n (Phone) APPLICANT SIGNATURE I '� I '1.L_P DATE ___Lop ` _ APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough-ins Dishwasher 0 Water Heater Floor Drain Water Softener Lavatory(Bathroom Sink) Stand Pipe(Washing Machine) Laundry Tray(I or 2 compartment sink Sewage Ejector Shower Stall _ Backflow Assembly Sinks Backflow Assembly Test Bar Sink _ Lawn Sprinkler Water Closet(Toilet) Other FEE The Minnesota Statutes.-§-326$.148 jot:cost with$49.50 minimum ini um Residential,New One&Two-Family $149.50 "SURCHARGE"has been extended • - Residential,Additions&Alterations $49.50 The minimum surcharge for a ' "fixed fee"permit is$5.00 $ Building Perm 9it#C -PLUMBING PERMIT FEE $ 9 ,S(3 STATE SURCHARGE $ XXX 5.00 TOTAL PERMIT FEE $ Sc( .SC) (Office Use Only) • This Application Becomes Your Building Permit When Approved 'd c ,\ -,"/ Receipt No. I 0' ate , By / Bulldine Official Date �C _I- `A L� 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372 , ll