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HomeMy WebLinkAboutPlumbing Permit 15. 0922 5 0O n 000000 0 > z0 2 o0 O ■ i § mnm o o � � tri / 79 m m m z /E. 0§ m xi 0 0 °SR q q 0 Z $ Q> Q P +373§ tl� - » -I m § o zz+3o ■ 2 / z 073r_ \ - ' o > o m m ■ § 7 _ Ni 0 72 0 m ■ o0 000000 ..'i x L mm ate ® * sem O -1 § ° 0 - > m _ 7 z f i § m ; s A n@% ■ 0 / ZZ — Z in z k . Q m - z q q 0 § r 2 x x ■ _ . c 2 # m r_-% o m / 0-ri . 0 k 0 •Q § .� E 1. 2 - 2 ❑ 0011 -0 > R. 0 WI IA < �. Cs -a / x ? til 0 . » nE � 4 m _ ximx0 -1r. 2 § $ 0 m 4� PRI� �.� e3ateiRec'tds, CITY OF PRIOR LAKE PLUMBING PERMIT +f "C kivESO I.Blue File 2. GoldPERMIT NO./5 lCity r ©� G/ 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONINGoffice use) 3377 cc �S �' -- $ 6(J . �fi LEGAL DESCRIPTION(office use only) (� LOT�LOCK2 ADDITION d)({/L,.S 111 Aar/ PID q C L-(_o I a--C OWNERyy (Name) R ��f S t"CO lVZ (Phone) 6(2 - 37,S - ( I57 (Address) 33 7 2_ i_S 6-1m APPLICANT (Name) a0C- V (0;,,1(�i� �� (Phone) g PZ-• (Address) CO It () 1-zS 7 537 L (Address) (City) (Zip Code) (Contact Person) �~— (Phone) /7 r 2 7cr 6'g'7 APPLICANT SIGNATURE .. DATE 27//43/4-C w//-C APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath T I 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 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 $ Building Permit# PLUMBING PERMIT FEE $ 4` S STATE SURCHARGE $ $1.00 TOTAL PERMIT FEE $ 50 S 0 (Office Use Only) This Application Becomes Your Building Permit When Approved Paid 50.G-1) Receipt No.zs-D Date ''11 ] I Building Official Date (v lc By <� � 24 hour notice for all inspections(952)447-9850 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372