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HomeMy WebLinkAboutPlumbing Permit 15. 0203 Ui z of k •71 � � � . ww - tQ0 « ¥ 0 z k tu k� �� j z ] um ■ 0 z z 0000 1 ' § g © 7 u § 0 iu ■ x 0 et ■ § w 0 a. a. - « § k Z o Z o o -J z 0 0 4. i ƒ I- Ct _2- 222 . C, cau § t 0 S a co Ce ' 2 0 2 li $ ° ° § 3 8 Z ~ aM§ ■ aM § § § § 2 OCOQOO O re rej tu % 0 o Z w a a u x CI D NI / Z 5R 0 a° k in ■ 2 z z § Cl) co E o r. 2 Z 0 2 2 a 1 4( I- I- 4 aR 2 2 zo ? � z_ W w w -a m B� IT Ce w 8 § 304 2 rezcc « § ,$ re § �2 �2� § Sv U 5z « 0 a 000000 0 0 / clx_5 5(4 . 5 v c eg__ (470 .kcp . . -., . yli., i 0,5%. CITY OF PRIOR LAKE PLUMBING PERMIT . bate Recd I.Blue File tease a Or 2.Gold City PERMIT NO. `� Zv`� rant and si., at bottom 3.Yellow Applicant ADDRESS _ 5 Mar � l ZONING(office use) LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION OWNER PID I (Name) al''la Von Q h I � (Phone) i _ — x1 (Address) S 1\----e APPLICANT (Name) - 'a //t-) 1 L 61 (Phone) _/ 2 — • • — Ast. . (Address) ma 4/ )&'14/ . w N .I (Address) I ( ity) Code) iis (Contact Person) '^ - / eo (Zip APPLICANT SIGNATURE AM�---/�/�// DATE ... Ij APPLI'ANT PLEASE COMPLETE BELOW T t e of Fixture IIIIIIIIIIM Bath Tub with or without shower Quanti T .e of Fixture 11111111111111 Dishwasher _r Floor Drain ��'_ Lavato Bathroom Sink "ater oftener 11111111111.1111111 Tra I or 2 coln.artment sink -I Stand Pi.e Washin: Machine Min Shower StallMIME 1111111111111111Backack floo Assew Assembl 111.1111111TIS"1111111111.11.1111110111111111111111.�_ Backflow Assembl Test 11.11111111 Water Closet Toilet Other T}1e Minnesota Statutes - FEE SCHEDULE "SURCHARGE„ 326B,Z¢g jo>}cost with a$49.50 minimum ltas beet]extende(I Residential,New One&Two-Family 5149.50 The inintltt lIfl sui c}iat a Residential,Additions&Alterations $49.50 "fixed fee" g fot a permit is$5.00 $ Building Permit# -PLUMBING PERMIT FEE $ Yg_l____ ___!� STATE SURCHARGE $ (Office Use Only) TOTAL PERMITTEE $ X � 5.00 • This Application Becomes Your Building Permit When Approved Paid ,— a iiip o.—7 ct 2_ BuUdine Official Date By Datc S/ MIMI I 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 i ! 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372