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HomeMy WebLinkAboutPlumbing Permit 15. 0948 1 ■C.) 2 �§ r: 4 = re 1 �86 � « w ai }222 O Z / .c..j 1 kk��k 2 k ] gOocO re � > co ■ oJ 2 .44 et _ iti ki Ci a. a. -I - w Z e 0 ui \ yr ■ ���� / 'a ui k3 § xiri 33 } 0 CO 0 $ a. X§§aa ' 22 CO X QC 000000 0 0 re z % 0 % 0 § cL m DI W w ■ z \k Z / z §2 0 z 0 § CO k z o la /-. ■ U �2 co z 0 < 01- u) ww 0� la Cg w �33= « 2 :C:14 1-$ § 0 222§x§ 0 § ■ ■ 2 U ■ < 0 a 000000 U ■ E 0 0 / of PR/04, CITY OF PRIOR LAKE PLUMBING PERMIT ec'd Date Recd / / /AWE SO I [ `I/ L I Blue Fde PERMT NO. �� Q Gold nu 1lle. viPlease t, r ands",athouomADDREss `s+ �,r i- 1 ZONING t.;a user LEGAL DESCRIPTION Office use only) �� LOT BLOCK ADDITION ��] /� OWNER, eIR PID c93-- J [a l C/ (Name) N N �j ,}9 r_ (Address) 1 r . �. „ t, — (Phone) © n �[3 �)�ct 10 APPLICANT ' ��f/� (Name) C 6fi'1 CI c' (Address) 5 (Phone) (-,_____ ,___L- 3 Nil y�f (� c M•i(c.e. (Address) Lt I 1_Q1 Lk ()ct,Gq5 /�6f?. ������1(re���� { 1(--/-C (City) > ��t.S�( (Zip Code) (Contact Person) APPLICANT SIGNATURE / (Phone) 6:'/,1 ��6,_�;t'/j-j Ie�CP�(� Com ,, DATE 5'-lte •,>?C!s---- IIIMEMIN APPLICANT PLEASE COMPLET T • of Fixture E BELOW Bath Tub with or without shower S napti Dishwasher --------- T of Future Rouen Heateres - Floor Drain Water Softener -- Lavato (Bathroom Sink) - Water Softener Laund Tra' I or 2 com. - Stand Pi. Shower Stall attment sink (Washin_Machine - Sew.!eEAsse . ar......._____111111111111111 � - Backflow Assembl ggimin Backflow Assembl Test 11111111111111111111 Water Closet Toilet - Other Industrial,Commercial&Multi-family I%ofjob cost with a FEE SCHEDULE 549.50 minimum Residential,New.One&,Two-Family S149.30 e► Residential,Additions&Alterations 549.50 Estimated Cost S_-._ ?'--- - Building Permit# PLUMBING PERMIT FEE $ STATE SURCHARGE $ '� totrrre caepay) TOTAL PERMIT FEE $ 1.00 This Application Becomes Your BuildingPermit rmit When Approved Paid Se, ReceiptNo / 11aaitdOiraiel pate Date _ r iag 24 hour notice for all inspections(952)447-9850 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372