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HomeMy WebLinkAboutPlumbing Permit 16. 0050 6 0 1 n cOOQOO 0 n n n a 0 0 . 0 ■ 11 - m � � § $ 0 KJ 2 » o xi XI 73 E riz■ oo z m Zrrsk� z co -IM ttit � q 2 $ d§» § P c oto � -1 73 > • 0 _ o5 % o a a --1 Z B m z r. § 7 f . . � � "0 -0 % Z 2 § o M » m 2 000000 II k kgi 0 p mr � > mr ) cl z ? CA 0 = _, 0c ms min C 'M 9, 0 W ■ W m O 0 \ > OgoC)0 m c -1 m 0 $ ■ xx - c Z z / i mLl r xi gi m ■ 0 . O q E m O ❑ Oco C z R. v © CAm]§§ '111%.*-- zITI > q ' , > m2 _11 73 -nx � 1:: � K m - I 0 ( j ) RDate Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT 1. Glue FiCie PERMIT 2. GoldApp NO. /6, „ty50 3. Yellow Applicant (� (Please type or print and sign at bottom) ADDRESS ZONING(office use) (A NssWODb C cc k c �'V LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER �"t • (Name) ►'Vfli,si) "�h i l ' , S (Phone) to ./11D 9 'S (Address) 35 64 SSw 0 O C 1 rG)e S APPLICANT �Z-75Q 9� (Name) 1ST � M E(%�1�Ps N i e'P' 1 r� �ti1[ (Phone) q (�-S 0 (Address) �Q 20 6-44" St D\) 1.4) Neil f�A UI 5b07 (Address) (ity) (Zip Code) (Contact Person) t f\-Q i£ S-�`�� (Phone) 9 52 7 s Z-5 APPLICANT SIGNATURE L2G �-�—(2- - DATE I) i O/i,r% 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 $ 9 I - 5 O STATE SURCHARGE $ $1.00 TOTAL PERMIT FEE $ 5 o , 5 0 (Office Use Only) This Application Becomes Your Building Permit When Approved Paid `_0_so Receipt No.3 Building Official Date Date �� l By C� �E 24 hour notice for all inspections(952)447-9850 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372