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HomeMy WebLinkAboutPlumbing Permit 15. 0628 � z 1 § . 2 T. § z � � a 0 % �4N - § 5 \ \ z ` k § aaa = o e ■ ww � . o « m < 85 i , 0 100 or § ■ I. ocO ❑ cO 2 0 . § ce x 2 N o faw z aa � > 14 § ■ OO2 _1 z 0 X Z B Z ZIZ . : 0 c a § © S 0 2 2 z 1 a z 1 w 0 z | _1tuI § _1 � o o § o a ■ ■ tea ■ § w § w k tr' O ❑ cOQO 00 cc 0 IL % i a a U = o w 0 < k U k g - § 0 0 . ; $ % e 0 z q 0 § i• I « I W z i a « I- I- % a@ ■ z zo -5 z W ` .- 2 S w w § � CL re IX o /� o E 0 u. } uk � § o 0 / ° / 8 ■ 0 0 i 000000 U 1 ,0 0 S. PRIp ' Date Rec'd p-, CITY OF PRIOR LAKE'PLUMBING PERMIT 3 drso��` , . �. Blue Fite I PERMIT NO. / - (Please type or print and sign3. Yellow Applicant at bottom) / ,.- ADDRESS I 1 ZONING(office use) r i y J A ) `, 6 LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION5/1PID 2 (O1VaWm ER , 1,s'-4-1 ,;�4, t' E : , i 4r J ) ;.)-(i' , (Phone)f i t. 4./sI,f1 ,} I i V w (Address) _ (;;' - APPLICANT (Name) ,;ince Connections Inc. I,4850 Chestnut Blvd. (Phone) (Address) Shakopee, MN 55379 (Add/W-445-4803 (City) (Zip Code) (Contact Person), la hrl k � i ..,„ - (Phone) APPLICANT SIGNATURE t` KL-b ,l ' k;',2,--1) d DATE )iit i :\ 1 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' I ,'(- ' Backflow Assembly-Test Bar Sink Lawn Sprinkler Water Closet(Toilet) Other FEE ULE Industrial,Commercial&Multi-family 1%of job cost with$49.50 minimumi Residential,New One&Two-Family $149.50 Residential,Additions&Alterations $49.50 Estimated Cost $ Building Permit# PLUMBING PERMIT FEE $ `7 r ,.) STATE SURCHARGE $ ,_ :50- (Office Use Only) TOTAL PERMIT FEE $ 7-• I This Application Becomes Your Building Permit When Approved pp s Receipt No. t 1: Date1 r� / g Buildine Official Date y C'- '" gin ` 2 ''. 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372