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HomeMy WebLinkAboutPlumbing Permt 15. 1437 w ;: ro 2 2 2 � �� � k §■§ uUi 2 « litlii 12 z 3 Z 2 22 0 _ • 3U � � 0 ,� u o k OOOOO 0 § \\ft & L z -- 0 Ea 0 ■ w 2 ��$ 0 \ 0 0 § I- a 0EIT -4 a I 04 s m 2 =$ § ■ . 0 0 2 1- 2 0 0 w §f���x b § 2 2 = u WW 2 § © �2& tea§ o � E OOOCOO %I � � k 0 k o 0 © o cs \ F6) i $ k § o a 2 t- o 2 x b 1- 6 Q U W -� o% § u) i et cd w III k 0 \ a.� ■ $ iz�� �� ui 2 © 8 a �Q ci w ,izi- e O 0 ow ■ $ 0 2U—U— 0 kk0 o a 000OOO 0 pi YRto Date Rec'd N CITY OF PRIOR LAKE PLUMBING PERMIT r "v � 3 &I. S� rr 41 SO° 1. Blas File PERMIT NO. /577 8 7 2.Gold City ` 3. Yellow Applicant (Please type or print and sign at bottom) vv ADDRESS n / ZONING(office use) /7a5-3 13��r l`i k ..12 r. S R / LEGAL DESCRIPTION(office use only) LOT69 BLOCK Z ADDITION 9e):+ 151? 2A/A/ PIN 25-3.72- 475-7-o OWNER (Name) � (Phone) 9 — k',.3 t5'Z � —efZ9 O (Address) /'7 ,-51.? ,0�r'I/-d.iJ r. ,r&- ,q1 D/' / /WV 56372_ APPLICANT ,/ / (Name) /®/ 6->/c5:41 (Phone) /�5�S,�0 ePd ,7 (Address) -991740 )r ; _ 3S1,0i (Ad. -.$) (City) (Zip Code) (Contact Person) ( 11/72 CZ-A 4,6er----' (Phone) ,7/6-----3g10 ---gO6 7 APPLICANT SIGNATURE J DATE r/la�/ 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 / 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# PLUMBING PERMIT FEE $ STATE SURCHARGE $ TOTAL PERMIT FEE $ - .c 5) (Office Use Only) This Application Becomes Your Building Permit When Approved Paid 6-0 Receipt No. 36 9 Buildine Official Date Date . Qy 5 (..""------ 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372