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HomeMy WebLinkAboutPlumbing Permit 09.0035 E 000 0 O 0000 o �: E k § § § q�B� oo' 0 ma 43�4 eco m o k r 1 k 27 m _�c§§U § co �� m r n 0 0 C 2 $ i G) � � ~ , § m 2 o z tta �� § • cn 0 sol § § z q - z m m 0 c m tti o 7 - - , § � -n 2 f 277 U LI CD 000000 . • M � mm ■� ■■s� .- Z 0 0 ? m 0 a ` 712§23�k m © ► 0 a zzz �z m o b X , % m , 9 > 000 0 ■ -4 m hi Z : o rm00 @ - P p 0 § . . 0 CD r k , p mo / au 0 p | . I n 0 �_ ' cl ] � ' �' 000000 } 2 § �, �na�2 §§ GI� § <R. a . 0 L z �C__r� kA, \ . . a22EiI § 2 �zk r� o ((p RIpDate Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT a 9, 0 7 U jNNE 1.Blue File 2.Gold City PERMIT NO. 0 a 0 3 + 3.Yellow Applicant 9, (Please type or print and sign at bottom) ADDRESS ZONING(office use) 670 61}41c:/k)rl4/ - LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER (Name) 7 (46 5(61 S (Phone) ,i o2 - 2Q6 - q(o j.e (Address) )L 70 3 / ,, 50r ti ‘.5-c— APPLICANT (Name) t'CS 17 /0/r..,4f, 4A de/4^ .. /11 (Phone)7G3- '7 7 - 9`./3-I 1 (Address) /1 V® ,--1-4,-7 Sa f3✓'L /r/, /= /j m.(4/7 V 53-37 C (Address) (City) (Zip Code) (Contact Person) 1704 o tiN 4 (Phone) 763-4-/77 r/5". . APPLICANT SIGNATURE / - DATE 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) I Stand Pipe(Washing Machine) Laundry Tray(1 or 2 compartment sink Sewage Ejector Shower Stall Backflow Assembly Sinks Backflow Assembly Test Bar Sink Lawn Spri ler �/ Water Closet(Toilet) t Other 7/S t-1 E 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 $ artg0 Building Permit# PLUMBING PERMIT FEE $ (1,‘S71 STATE SURCHARGE $ .50 TOTAL PERMIT FEE $ wa O ) (Office Use Only) This Application Becomes Your Building Permit When Approved Paid Rec t No. Date 7 Buildine Official Date /,24, d , 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372