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HomeMy WebLinkAboutPlumbing Permit 15. 1103 0 0 n 24 0 g ■ n 000000 E f c § 2 0 ■,= T ,1 � § $ g �2 2 � ® klcco m m 2 � � . 2 Ilw a K ��z z k �" � 4 0 © cn -I m §®• � Z� % C7 - D. 0 0 cn g z ' /k \ Zi / k k D �� 0 mm m o z m % Z 7 k 0 _ / X 2 m m �- % 000000 � r z ? $ o o , � � ■* ■� / / § , m _ ns _I §c % k m 1, 7§2§7§ m p 0 ® )0 S 0 K§Q§ 0 E -4 X / z m l 1-.11. u0 z p § / 7 0 § C m o _k m % > z 000000 k &m20§ § 7 � c §9§ ® - ›,00PI g i64 2 IC 0 1 PRIp� 6 CITY OF PRIOR LAKE PLUMBING PERMIT Date Recd q, 1 --, ISv I. Blue File 2.Gold City PERMIT NO. / r , ease j' or t and si at bottom M 3. Yellow Applicant '2— i ZONING(office use) M1J •v5 6 LEGAL DESCRIPTION(office use only) LOT BLOCK 7 ADDITION` , OWNER PID �A9 - �•'r�j�.,, (Name) g i C (Address) (Phone) - 1 . 7 Q •APPLICANT (Name) A• pian - '. - ,- (Address) 12850 hestnut Blvd. (Address) (Contact Person) '�?n3 ! (Zip Code) ft (Phone) APPLICANT SIGNATURE _ �__.. � �� ..� / DATE_ 9 II ''S - _-_,..... COMPLETE BELOW Quanti T t e of Fixture 111M MI Bath Tub with or without shower T/t e of Fixture Dishwasher ���' Rough-ins 1111111111111111 Floor Drain Lavato Bathroom Sink Water Softener _� Laund Tra 1 or 2 corn.artment sink __ Stand e e Washin: Machine __ Shower Stall E'ector -- Backflow Assembl Bar Sink 111 Backflow Assembl Test 111111111111111110 IIIIIINIIII Water Closet Toilet IIIIIIIIIIIIIII Other Industrial,Commercial&Multi-family 1%of job cost with a$EE9.50 CHEDULE R , Onmily $149.50 Residentialesidential,New Additionse&Ttyo-Fa&Alterations $49 5.0 The Minnesota Statutes§326B.148 "SURCHARGE"has been extended Building Permit# The minimum surcharge for a ,UMBING PERMIT FEE $ r CD "fixed fee"permit is$ i.00 ATE SURCHARGE )TAL PERMIT FEE $______%__ _____ This Application Becomes Your Building Permit When Approved Paid .---1! Receipt Na #� ��' � � � Building OfficialDate Date S By 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 I 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372