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HomeMy WebLinkAboutPlumbing Permit 15. 0475 I 0 O t? n 0 � � o 0 oO0000 0 » 2 o ■ m.0 ■31§ "Im 'n 7 & 8 k/ t . 0 o k -(2 31 m k omo 10 '1M $ ;zoz z 0) co $ 6 �0o @ -I m /© ® z-x xi2 2 cn o z k z$ el 0 xi / z 2 z q J —1 r o % X iii To CA m ni § J -I 2 20 OooQOO $ J 1/) RI ' 2mz■ § k k -n§■ ■ xi §z - z m 0 o k Q z › o/o 0 ■ z w § 2 ■ 7 . !L § / i § /- §§ Z m o m r o _k < ..___. f y m � J �ooOOO �� . � R. < ei cokkE§ - V § 4 ETI 0 > 00k- \ p a _ � 2 . 4- -4r o - of PR`o� C......F CITY OF PRIOR LAKE PLUMBING PERMIT Date Recd ri I. Blue L I PERMIT NO.I5Q�Jpy5d C '�"-1(Please type or prnt and sign at bottom) p Ar ADDRESS n 430� 1-'Yl o r�J Oc�� SIZONING(office use) `. LEGAL /DESCTION(office use only) j,IL 4z/o3 LOT (/ O K / ADDITION -G ►rhe !� 6 �t h,�rf PIDA33 /" /10 —a OWNER (Name) -To,.r\I LA_ �1 v o rr\A-C (Phone) 7b 3- .:3d/ - 097 7 (Address) APPLICANT (Name) CULLIGAN WATt - CONDITIONING (Phone) (Address) 6030 CULLIGAN WAY ' I Ie 9NKA, MN 55345 (City) (952) 033-7200 (Zip Code) (Contact Person) (Phone) APPLICANT SIGNATURE (13;_itirut:_i DATE I -30-�L5 APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Bath Tub with or without shower Type of Fixture Rough-ins Dishwasher Floor Drain Water Heater I Water Softener Lavatory(Bathroom Sink) Stand Pipe(Washing Machine) Laundry Tray(1 or 2 compartment sink Sewage Ejector Shower Stall Backflow Assembly Sinks Bar Sink Backflow Assembly Test Water Closet(Toilet) Lawn Sprinkler Other F E Industrial,Commercial&Multi-family 1%of job cost with$49. 50 minimum Residential,New One&Two-Family $149.50 Residential,Additions&Alterations $49.50 Estimated Cost $ Building Permit# PLUMBING PERMIT FEE $ STATE SURCHARGE $ .50 (Office Use Only) TOTAL PERMIT FEE $ ,_ 5 y, 5 0 This Application Becomes Your Building Permit When Approved ',id V Receipt N.. Buildinc Official ‘Date By Date _ 1.— AiAM 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 Or 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372