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HomeMy WebLinkAboutPlumbing Permit 15. 1157 QJ 4 w Z re _Z F- h J ct W E ZV a < (N Z Rl i iggZ <aaa ❑ 0 0 ili �^ mp� � N c� z C7 < �! O pi.-woir � o 1 tx z EN 3 ❑ ❑❑ ❑ ❑ CT ,1 w o 0 N 0 W z » = m c 0 O C m 0OIJ z 0 F 4 _ OO to V 0 z w Zu w H C I m 00 ", w 0 a 2xw px a 2 „_jw < yjJw C G Z_ X p a23maa - WU w w w 14, a. ❑ ❑ ❑ D ❑ ❑ O o x zIx oC al N a a u. x / dr. J a' w 0 0 < UU Er-14.1 � Z o Z v to < ; r- 01 dce� 0 CD O = N ww J w H W16 ZaJz W a <J Au.vw Ce z30 < w r, o wwvv v V a. G O u. zU0< a c3 = 0 D❑ ❑ ❑ ❑ ❑ Q ❑ ❑ c �4PRI�+P `✓ E°" CITY OF PRIOR LAKE PLUMBING PERMIT Date Recd �l't'NESo�� Fct PERMIT NO. /5- Or and at bottom 3.Yellow Applicant I ADDRESS `7 -7 3 4 Lam.►, �r,„ Le-k, zoIVIlVG(office use) LEGAL DESCRIPTION(office use only) LOT BLOCK 6 ADDITION 1 I C-94:0_ PID Z S- *569"--- C a ro OWNER (Name) C r^n G q ar- (Phone) (Address) �-]7 - _ b APPLIC (Name) 1� �►� � ■ Tr �.1I. ' • (Phone) et-52-- y 5 3 -- 11(©13 (Address) 1 • • (Address) J• 05-0 (City) (Zip Code) (Contact Person) Jc71�„G G � /, ,�7t (Phone) �SZ - 95 3 - 7 3 APPLICANT SIGNATURE .4• L _- _,-__ DATE 2.Z. APPLICANT PLEASE COMPLETE BELOW uanti T t • of Fixture Quanti T t • of Fixture Bath Tub with or without shower Dishwasher Rou: -ins DrainWater Heater Floor LavatoBathroom Sink Water Softener Laund Tra I or 2 coma artment sink Stand ePa e Washin_Machine Shower Stall _� Sewa:e E'ector Sinks Backflow Assembl Bar Sink Backflow Assembl Test IIMEMillimmum Water Closet Toilet ' Other SCHEDULEFEE 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 $ STATE SURCHARGE $ $100 (Office Use Only) TOTAL PERMIT FEE $ This Application Becomes Your Building Permit When Approved Pai•- � Receipt No 2g er Building Official Date By Date L 24 hour notice for all inspections(952)447-9850AO 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372