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HomeMy WebLinkAboutPlumbing Permit 15. 1320 5 ❑ c n 000000 1 . 0 » E0 n n k 0 0 0 0 �zoV) 0 Z m 73 MO tz r 2 X X X s mAr ■ a � ■ ■ 0m % r m co m ■ 5b E o z z Cl, % � q m - -I P Z§ q �- @ cn m 0 Z § ¢ "n 0 ,� m m r Z 3 % m § 0 X VI .0 m 2 0 o 000000 rfl § M q 'di Elim ■ Em E -1 § Q Q R■� OC -10c .! 7 ' to ? m . m13 ;373731" C ¢ ( xm 0 SE MIC m Co E m ] > 090 0 m `a 2 U 0 2q § 2 # m 111 > cc rmml P N- 0 2 4' 0 I m * § 1i0 0 '00000 — Li E J 222 § ~ a 0 © �� � � � . \ 0 ,, §� E § ,, � � r c -i § 0 4"RI0 Date Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT Via. z Z,iS v p,, ES°o File PERMIT NO. • 2.Gold App /�� �v�� 3.Yellow Applicant !!! (Please type or print and sign at bottom) ADDRESS ZONING(office use) L3L W ‘1cY 0cJksI riekc—L S LEGAL DESCRIPTION(office use only) / �/ LOTI BLOCK ADDITION j(/� � G `� PID ( 4I.. 0/)D OWNER S4er �v�rZ�) eWS k1 I - d (Name) J (Phone) a � 0 - a �S (Address) APPLICANT (Name) CULLIGAN WATER CONDITIONING (Phone) 6030 CULLIGAN WAY (Address) (A eN I NNss TONKA, MN 55345 952) 933-7200 (City) (Zip Code) (Contact Person) (Phone) APPLICANT SIGNATURE ) DATE 10 -g - 15 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 1 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 $ 15 91.• n O Building Permit# PLUMBING PERMIT FEE $ STATE SURCHARGE $ TOTAL PERMIT FEE $ So .50 (Office Use Only) This Application Becomes Your Building Permit When ApprovedPaid 60 ,(;O Receipt No.3 2-1 Date Building Official Date I O . 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372