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HomeMy WebLinkAboutPlumbing Permit 15. 0859 _ n 000000 1 o a $ § 5 0 / ■ 0 § JK-n -n � 0 7 0 o s § g 0 k k 2 m 2P \§¢ z z Xi 0 24 73 k � 0 ■ 2 © -- • Z0 10 j 73 ■ = Cn 9 z k % _ �� 0 2 1 b rn m 0 lipjo z ° % \ xi F. 0 " x o xi 7 000000 gm m m m F § A\ otm § k -4 Z0 D 2 § � 2ii -0 0 � _ §mm 0 2 7 § % f rn (ii) > 000 § 3 m r � § o ,3 o 5 c6 o § m o " 2# q kj . )600000 K ?na A 0 -n :Bog `1 trl 0> � � 20 R. 2 0 i mk\� o rq Z 73117 n ■ § 4r § ��- -7( 6/i1•4%/9 � Date Recd CITY OF PRIOR LAKE PLUMBING PERMIT 7• z7, �✓ 4-1111-/-- %5 co L0,3 I.Blue FAile /PERMIT NO. /tL//�N J=/�y�J�j 2. Applicant (i (Please type or print and sign at bottom) ADDRESS ZONING(office use) 1LY9 5O t-\ ,IIsick Circle NUJ ,_Ss'_377� �UD LEGAL DESCRIPTION(office use only) �, 4411.5 /,,� p� / LOT/ " BLOCK ( ADDITION 5/�T�'�/) �.C�. hi 11.5 PID (15-307_ OWNER (Name) €5 C t O.r JCo vne-1 o► � (Phone) 9S�- - a a l - 35 (Address) APPLICANT (Name) CULLIUAN WATER CONDITIONING (Phone) 6030 CULLIGAN WAY (Address) MINNETOf4KA, MN 55345 (Addres�52) 933-7200 (City) (Zip Code) (Contact Person) (Phone) APPLICANT SIGNATURE 12DATE 7- IL - APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough-ins Dishwasher Water Heater Floor Drain J 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 SCHEDULE 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#a PLUMBING PERMIT FEE $ 4 "l. STATE SURCHARGE $ TOTAL PERMIT FEE $ .Sb• 5 0 (Office Use Only) This Application Becomes Your Building Permit When Approved ro=14111111; Receipt No. Date By Building Official Date 24 hour notice for all Inspections(952)447-9850,fax(952)447-4245 — • 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372