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HomeMy WebLinkAboutPlumbing Permit 15. 0884 -ii-.1 zUtilWW J !aWi~Nat� i Z Z w Z ,, y 1 ❑ ❑ ❑ ❑ ❑ > AWL fir, 0 o x N W L Z O _ IK �---) H a a J i m C LAI p li z tc O $ " Q 0 y a j W z w Z _ xxZ ? 0 u- 10 c U) O y 0 d 2SWWmx ,x 4 _IW < y6m0 W W W X Lt, ce re ZUj c O. a LL f- p J 1 ✓ c Z J 0 W �J 0 Z 0 o o .4 g0 97 ° N u- ,4 co c a O Z \ „ a O O w Z < "1 ' 4 Z w IQ 1.4 Z (7 ~O � a V LL O (co I) Z F 0 a -I z— 1sv 1J Y re re C < C U. O O O t5 V LI 0 a Z 00 0 O °O �= � v) p 3 0 i N ❑ ❑ c 53 s 0 a 000000 V QpRIO OCITY OF PRIOR LAKE PLUMBING PERMIT Date Rec d r0e i.Gold Pile I PERMIT NO./5 8 2.Gold Ci (Please type or print and sign at bottom) 3.Yellow Applicant ADDRESS( �p &ifl / / i xi Mi 5537 ZONING(office use) LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PU) OWNS 64.'iviry d 1 (Jrt,su / (Phone) 9,5,/--7 /C%! 7 fLJ` `lo (Address)& 7E- FO„.. )� l/ �� G 5s 7A APPLICANT (Name) Atf1/ 1 an / on JL (Phone) (Address) tick // —„ej/ ! • (Address) (City) (ZipCode) (Contact Person) JQYV% 1 f` (Phone) —v r 95a 44 �1 U 03 APPLICANT SIGNATURE t , /,1 • DATE �z �I ���' �'C APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixtureuanti Bath Tub with or without shower Q Type of Fixture 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 Industrial,Commercial&Multi-family 1%of job cost with $49.50 minimumiResidential,New One&Two-Family $149.50 Residential,Additions&Alterations $49.50 The Minnesota Statutes§326B.148 $ Building Permit# "SURCHARGE"has been extended The minimum surcharge for a LUMBING PERMIT FEE $ , "fixed fee"permit is TATE SURCHARGE $ • ©d 'OTAL PERMIT FEE $ 5a S0 This Application Becomes Your Building Permit When Approved Paid �.i �v s---0 Receipt No/J/ ``�� �i� uilding Official Date t By �jj��l/ Date U 3, i S� / B 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372